title: Genotypic diversity of anogenital human papillomavirus in women attending cervical cancer screening in Harare, Zimbabwe.
abstract: Although anogenital cancers have been on a gradual rise in developing countries in the past few decades, they have been understudied. The objective was to investigate genotypic diversity of anogenital HPV amongst women reporting for routine cervical cancer screening in Harare in Zimbabwe. A cross-sectional study that enrolled 144 women ≥18 years from a cervical cancer-screening clinic was performed. Each woman provided a self-collected cervico-vaginal swab (VS) and a clinician-collected anal swab (CCAS). HIV testing was offered and cervical cytology was performed. Both VS and CCAS samples were HPV genotyped, using amplicon sequencing of the L1 gene region with Illumina technology. Mean age of the women was 39.9 (range 18-83 years, SD ± 11.0). HPV prevalence was 72% (104/144) in VS and 48% (69/144) in CCAS. The most common genotypes detected in both VS and CCAS were HPV18, HPV52, and HPV16. Sixty two percent of the subjects had multiple genotypic HPV infections. The odds of being HPV-positive among HIV-infected women were higher than in HIV-negative women in both the vagina and the anus (CCAS OR = 4.8; CI 2.4-9.8, P < 0.001) and (VS OR = 2.9; CI 1.3-6.4, P = 0.005). High HPV prevalence and diverse genotypes were detected in both the vagina and anus. Anal oncogenic HPV infection was common. HPV 52 was one of the most common oncogenic genotypes in both the vagina and anus. HIV co-infection played a significant role in the prevalence of HPV. These data have implications for design of primary and secondary programs for prevention of anogenital cancer in Zimbabwe.
authors.affiliation: Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Racheal S
authors.identifier: 0000-0003-1154-6829
authors.initials: RS
authors.lastname: Dube Mandishora
authors.affiliation: Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Irene K
authors.initials: IK
authors.lastname: Christiansen
authors.affiliation: Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Nyasha
authors.initials: N
authors.lastname: Chin'ombe
authors.affiliation: Department of Immunology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Kerina
authors.initials: K
authors.lastname: Duri
authors.affiliation: Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Bernard
authors.initials: B
authors.lastname: Ngara
authors.affiliation: Department of Research, Cancer Registry of Norway, Oslo, Norway.
authors.forename: Trine B
authors.initials: TB
authors.lastname: Rounge
authors.affiliation: Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Roger
authors.initials: R
authors.lastname: Meisal
authors.affiliation: Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway.
authors.forename: Ole H
authors.initials: OH
authors.lastname: Ambur
authors.affiliation: Department of Medicine, University of California, San Francisco, California.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
authors.affiliation: Women's Clinic, Rikshospitalet, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
authors.forename: Babill
authors.initials: B
authors.lastname: Stray-Pedersen
authors.affiliation: Department of Obstetrics and Gynaecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Zvavahera M
authors.initials: ZM
authors.lastname: Chirenje
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000821:virology; D036022:Capsid Proteins / Q000235:genetics; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer; D016021:Epidemiologic Studies; D005260:Female; D014644:Genetic Variation; D005836:Genitalia, Female / Q000821:virology; D005838:Genotype; D060005:Genotyping Techniques; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000821:virology*; D017422:Sequence Analysis, DNA; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D036022:Capsid Proteins
keywords: Zimbabwe; anogenital; genotypes; human papillomavirus; sequencing; women