High-risk human papillomavirus genotype distribution among women living with HIV; implication for cervical cancer prevention in a resource limited setting.

Autor: Akakpo PK; Department of Anatomic Pathology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Ken-Amoah S; Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Enyan NIE; Department of Adult Health, School of Nursing and Midwifery, University of Cape Coast, Cape Coast, Ghana., Agyare E; Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana.; Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Salia E; Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Baidoo I; Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana., Derkyi-Kwarteng L; Department of Anatomic Pathology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Asare M; Department of Public Health, Robbins College of Health and Human Services, Baylor University, Waco, TX, USA., Adjei G; Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana., Addo SA; National AIDS/STIs Control Programme, Korle-Bu, Accra, Ghana., Obiri-Yeboah D; Public Health Unit, Cape Coast Teaching Hospital, Cape Coast, Ghana. dobiri-yeboah@ucc.edu.gh.; Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana. dobiri-yeboah@ucc.edu.gh.
Jazyk: angličtina
Zdroj: Infectious agents and cancer [Infect Agent Cancer] 2023 May 26; Vol. 18 (1), pp. 33. Date of Electronic Publication: 2023 May 26.
DOI: 10.1186/s13027-023-00513-y
Abstrakt: Background: For women living with HIV (WLHIV), the burden of persistent HPV infection, cervical pre-cancerous lesions and cancer have been demonstrated to be higher than among HIV-negative women. As Ghana and other lower-middle-income countries (LMIC) work toward developing national cervical cancer programmes, it is essential that local scientific evidence be provided to guide policy decisions, especially for such special populations. The objective of this study was to determine the distribution of high-risk HPV genotype and related factors among WLHIV and its implication for the prevention of cervical cancer prevention efforts.
Methods: A cross-sectional study was conducted at the Cape Coast Teaching Hospital in Ghana. WLHIV, aged 25-65 years, who met the eligibility criteria were recruited through a simple random sampling method. An interviewer-administered questionnaire was used to gather socio-demographic, behavioural, clinical and other pertinent information. The AmpFire HPV detection system (Atila BioSystem, Mointain View, CA was used to detect 15 high-risk HPV genotypes from self-collected cervico-vaginal samples. The data collected were exported to STATA 16.0 for statistical analysis.
Results: In all, 330 study participants, with mean age of 47.2 years (SD ± 10.7), were involved. Most (69.1%, n = 188/272) had HIV viral loads < 1000 copies/ml and 41.2% (n = 136) had ever heard of cervical screening. The overall hr-HPV prevalence was 42.7% (n = 141, 95% CI 37.4-48.1) and the five commonest hr-HPV types among screen positives were HPV59 (50.4%), HPV18 (30.5%), HPV35 (26.2%), HPV58 (17%) and HPV45 (14.9%). Most infected women (60.3%, n = 85) had multiple hr-HPV infections, with about 57.4% (n = 81) having 2-5 h-HPV types, while 2.8% (n = 4) had more than five hr-HPV types. A total of 37.6% (n = 53) had HPV16 and/or18, while 66.0% (n = 93) had the hr-HPV genotypes covered by the nonavalent vaccine. Women with HIV viral load ≥ 1000copies/ml (AOR = 5.58, 95% CI 2.89-10.78, p < 0.001) had a higher likelihood of being co-infected.
Conclusion: This study found out that the prevalence of hr-HPV still remains high in women with HIV, with a notable occurrence of multiple infections and infection with genotypes 16 and/or18. Additionally, an association was established between hr-HPV and infection HIV viral load.. Therefore, comprehensive HIV care for these women should include awareness of cervical cancer, consideration of vaccination and implementation of screening and follow-up protocols. National programmes in LMIC, such as Ghana, should consider using HPV-based screen-triage-treat approach with partial genotyping.
(© 2023. The Author(s).)
Databáze: MEDLINE
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