Author:
Mcharo Ruby,Lennemann Tessa,France John,Torres Liseth,Garí Mercè,Mbuya Wilbert,Mwalongo Wolfram,Mahenge Anifrid,Bauer Asli,Mnkai Jonathan,Glasmeyer Laura,Judick Mona,Paul Matilda,Schroeder Nicolas,Msomba Bareke,Sembo Magreth,Chiwerengo Nhamo,Hoelscher Michael,Geisenberger Otto,Lelle Ralph J.,Saathoff Elmar,Maboko Leonard,Chachage Mkunde,Kroidl Arne,Geldmacher Christof
Abstract
BackgroundWomen living with HIV in sub-Saharan Africa are at increased risk to develop cervical cancer (CC), which is caused by persistent infection with 13 oncogenic human papilloma viruses (HR-HPVs). It is important to accurately identify and target HIV-positive women at highest risk to develop CC for early therapeutic intervention.MethodsA total of 2,134 HIV+ and HIV− women from South-West Tanzania were prospectively screened for cervical cancer and precancerous lesions. Women with cervical cancer (n=236), high- and low-grade squamous intraepithelial lesions (HSIL: n=68, LSIL: n=74), and without lesion (n=426) underwent high-resolution HPV genotyping.ResultsEighty percent of women who were diagnosed with HSIL or LSIL were living with HIV. Any lesion, young age, HIV status, and depleted CD4 T cell counts were independent risk factors for HPV infections, which were predominantly caused by HR-HPV types. While multiple HR-HPV type infections were predominant in HIV+ women with HSIL, single-type infections predominated in HIV+ CC cases (p=0.0006). HPV16, 18, and 45 accounted for 85% (68/80) and 75% (82/110) of HIV+ and HIV− CC cases, respectively. Of note, HPV35, the most frequent HPV type in HSIL-positive women living with HIV, was rarely detected as a single-type infection in HSIL and cancer cases.ConclusionHPV16, 18, and 45 should receive special attention for molecular diagnostic algorithms during CC prevention programs for HIV+ women from sub-Saharan Africa. HPV35 may have a high potential to induce HSIL in women living with HIV, but less potential to cause cervical cancer in single-type infections.
Funder
Deutsche Forschungsgemeinschaft
Cited by
5 articles.
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