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Tewari P, Banka P, Kernan N, Reynolds S, White C, Pilkington L, O'Toole S, Sharp L, D'Arcy T, Murphy C, Comiskey C, Martin CM, O'Leary JJ. Prevalence and concordance of oral HPV infections with cervical HPV infections in women referred to colposcopy with abnormal cytology. J Oral Pathol Med 2021; 50:692-699. [PMID: 33733523 DOI: 10.1111/jop.13172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/06/2021] [Accepted: 02/27/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Considering the shared aetiology of Human Papillomavirus infections in oropharyngeal and cervical cancers and the possible role for sexual transmission, several key aspects of the relationship between cervical and oral infections merit investigation, including prevalence of concomitant oral HPV infection and type-specific concordance with concurrent cervical infections. METHODS A cross-section study was performed on women referred to colposcopy clinics with cytological abnormalities and a cervical HPV infection. An oral rinse sample was taken from the participants at their baseline visit for HPV testing, and a demographic and risk factor questionnaire was also administered. HPV DNA testing was carried out on the Cobas 4800 platform and extended genotyping was carried out with the INNO-LiPA HPV Genotyping Extra II assay. HPV genotyping was also carried out on the concurrent cervical tissue samples on all women who had a positive oral HPV infection. RESULTS The prevalence of oral HPV infections was 10.0% (95%CI:5.9-13.7) in the study population. HPV18 was the most frequent genotype (7.0%). Concordant oral and cervical HPV infections were detected in 28.6% of women. Age (p = 0.005) and level of education (p = 0.02) were significantly associated with a prevalent oral HPV infection. CONCLUSION Concomitant oral HPV infections were present in 10.0% of women referred to colposcopy with a pre-existing cervical HPV infections and cytological abnormalities. Although mild type-specific concordance was observed between oral and cervical HPV infections, findings suggest that infections at these sites may not be independent of each other.
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Affiliation(s)
- Prerna Tewari
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Prakashini Banka
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Niamh Kernan
- Department of Histopathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Stephen Reynolds
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Christine White
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Loretto Pilkington
- Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Sharon O'Toole
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Linda Sharp
- Newcastle University Centre for Cancer, Population Health Science Institute, Newcastle University, Newcastle, UK
| | - Tom D'Arcy
- Department of Obstetrics & Gynaecology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - Cliona Murphy
- Department of Obstetrics & Gynaecology, Tallaght University Hospital, Dublin, Ireland
| | - Catherine Comiskey
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Cara M Martin
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
| | - John J O'Leary
- Department of Histopathology, Trinity College Dublin, Dublin, Ireland.,Department of Molecular Pathology, Coombe Women & Infants University Hospital, Dublin, Ireland
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Tounkara FK, Téguété I, Guédou FA, Talbot D, Traoré CB, Béhanzin L, Traoré S, Goma-Matsétsé E, Aza-Gnandji M, Keita B, Guenoun J, Coutlée F, Alary M. Type-specific incidence, persistence and factors associated with human papillomavirus infection among female sex workers in Benin and Mali, West Africa. Int J Infect Dis 2021; 106:348-357. [PMID: 33848674 DOI: 10.1016/j.ijid.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/31/2021] [Accepted: 04/04/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study in female sex workers (FSWs) aimed to: (1) estimate type-specific incidence and persistence of human papillomavirus (HPV) infection in Cotonou (Benin) and Bamako (Mali); and (2) identify the factors associated with type-specific incidence and persistence of high-risk HPV (HR-HPV) infection. METHODS A 1-year prospective cohort study on cervical cancer screening, and HPV and human immunodeficiency virus (HIV) infections was conducted among FSWs in Cotonou and Bamako from 2017 to 2019. Poisson regression models assessed factors associated with the incidence of HR-HPV infection, while log-binomial regression was performed to identify factors associated with the persistence of HR-HPV infection. Adjusted relative risks (ARR) and 95% confidence intervals (95% CI) were estimated. RESULTS The incidence of HR-HPV infection was 46.98 per 1000 women-months (predominant types HPV16, HPV35 and HPV59). Factors associated with the incidence of HR-HPV infection were age <20 years (ARR 15.10; 95% CI 3.29-69.19), age at sexual debut <18 years (ARR 6.92; 95% CI 1.97-24.27) and sex work duration ≤1 year (ARR 7.40; 95% CI 1.84-29.69). The persistence of HR-HPV infection at 12 months was 38.7% (most persistent types HPV59, HPV52 and HPV51). Persistence of HR-HPV infection was higher in women with chlamydia (P = 0.031), HIV infection (P < 0.001) and multiple-type HPV infections (P < 0.001). CONCLUSION FSWs in West Africa are at high risk of incident and persistent HR-HPV infection, suggesting an urgent need for cervical cancer screening in this population.
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Affiliation(s)
- Fatoumata Korika Tounkara
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Ibrahima Téguété
- Département de Gynécologie-Obstétrique, CHU Gabriel Toure, BP 267, Bamako, Mali
| | - Fernand A Guédou
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Denis Talbot
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada
| | - Cheick B Traoré
- Département d'Anatomie-Pathologie, CHU Point G, Bamako, Mali
| | - Luc Béhanzin
- École Nationale de Formation des Techniciens Supérieurs en Santé Publique et en Surveillance Épidémiologique, Université de Parakou, Benin
| | - Sidy Traoré
- Département de Gynécologie-Obstétrique, CHU Gabriel Toure, BP 267, Bamako, Mali
| | - Ella Goma-Matsétsé
- Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Marlène Aza-Gnandji
- Dispensaire des Infections Sexuellement Transmissibles (DIST), Centre de santé de Cotonou-1, Cotonou, Benin
| | - Bintou Keita
- Association de Recherche de Communication et d'Accompagnement à Domicile de personnes Vivant avec le VIH (ARCAD-SIDA), Bamako, Mali
| | - Julie Guenoun
- Département de Microbiologie et Infectiologie, Centre de recherche du CHU de Montréal, Montréal, Canada
| | - François Coutlée
- Département de Microbiologie et Infectiologie, Centre de recherche du CHU de Montréal, Montréal, Canada
| | - Michel Alary
- Département de Médecine Sociale et Préventive, Université Laval, Québec, Canada; Axe Santé des Populations et Pratiques Optimales en Santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada; Institut national de santé publique du Québec, Québec, Canada.
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McCann J, Crawford G, Hallett J. Sex Worker Health Outcomes in High-Income Countries of Varied Regulatory Environments: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083956. [PMID: 33918688 PMCID: PMC8070506 DOI: 10.3390/ijerph18083956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 01/01/2023]
Abstract
There is significant debate regarding the regulation of the sex industry, with a complex range of cultural, political and social factors influencing regulatory models which vary considerably between and within countries. This systematic review examined the available evidence on the relationship between different approaches to sex industry regulation in high-income countries, and associated effects on sex worker health status. Objectives included identification of sex worker health outcomes, including sexual health, substance use and experience of stigma and violence. A search was performed electronically in eight scholarly databases which yielded 95 articles which met the criteria for inclusion. Findings suggested that sex workers in legalised and decriminalized countries demonstrated greater health outcomes, including awareness of health conditions and risk factors.
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Affiliation(s)
- Jessica McCann
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; (G.C.); (J.H.)
- Correspondence:
| | - Gemma Crawford
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; (G.C.); (J.H.)
- Collaboration for Evidence, Research and Impact in Public Health, Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
| | - Jonathan Hallett
- Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia; (G.C.); (J.H.)
- Collaboration for Evidence, Research and Impact in Public Health, Curtin School of Population Health, Curtin University, Kent Street, Bentley, WA 6102, Australia
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Tounkara FK, Téguété I, Guédou FA, Goma-Matsétsé E, Koné A, Béhanzin L, Traoré S, Aza-Gnandji M, Keita B, Guenoun J, Coutlée F, Alary M. Human papillomavirus genotype distribution and factors associated among female sex workers in West Africa. PLoS One 2020; 15:e0242711. [PMID: 33237976 PMCID: PMC7688172 DOI: 10.1371/journal.pone.0242711] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/09/2020] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES This study aimed to: (1) Estimate HPV prevalence and genotype distribution among female sex workers (FSWs) in Mali and Benin as well as the prevalence of multiple HPV type infections in this group, and (2) Identify potential risk factors associated with high-risk (HR) HPV infections. METHODS We analyzed baseline data of 665 FSWs aged ≥ 18 years recruited during a prospective cohort of cervical cancer screening in Cotonou (Benin) and Bamako (Mali) from 2017 to 2018. The Linear Array HPV genotyping test was used to identify HPV genotypes. Descriptive statistics and multivariate log-binomial regression were used. Adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) were estimated to identify risk factors associated with HR-HPV infections. RESULTS HPV data were available for 659 FSWs (Benin: 309; Mali: 350). The mean age was 35.0 years (± 10.7) in Benin and 26.8 years (± 7.6) in Mali. The overall HPV prevalence rates were 95.5% in Benin and 81.4% in Mali. About 87.7% and 63.4% of FSWs harbored ≥ 2 HPV types in Benin and Mali, respectively. The top three prevalent HR-HPV among FSWs in Benin were: HPV58 (37.5%), HPV16 (36.6%) and HPV52 (28.8%). Corresponding patterns in Mali were HPV16 (15.7%), HPV51 (14.3%) and HPV52 (12.9%). In Benin, the main factors associated with HR-HPV were vaginal douching (APR = 1.17; 95%CI:1.02-1.34) and gonococcal infection (APR = 1.16; 95%CI:1.04-1.28), while in Mali they were sex work duration ≤ 1 year (APR = 1.35; 95%CI:1.10-1.65) and HIV infection (APR = 1.26; 95%CI: 1.06-1.51). CONCLUSION Our study found a very high prevalence of HPV infection as well as high frequency of multiple HPV type infections in FSWs in two countries in West Africa. These findings suggest the necessity to emphasize cervical cancer prevention in this high-risk group.
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Affiliation(s)
- Fatoumata Korika Tounkara
- Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec—Université Laval, Québec, QC, Canada
| | | | - Fernand A. Guédou
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec—Université Laval, Québec, QC, Canada
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Ella Goma-Matsétsé
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Amadou Koné
- Centre Universitaire de Recherche Clinique (UCRC), Bamako, Mali
- Des Techniques et Des Technologies de Bamako, Université des Sciences, Bamako, Mali
| | - Luc Béhanzin
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Sidy Traoré
- Centre Hospitalier Universitaire Gabriel Toure, Bamako, Mali
| | - Marlène Aza-Gnandji
- Centre de Santé de Cotonou-1, Dispensaire des Infections Sexuellement Transmissibles (DIST), Cotonou, Benin
| | - Bintou Keita
- Association de Recherche de Communication et d’Accompagnement à Domicile de personnes Vivant avec le VIH (ARCAD-SIDA), Bamako, Mali
| | - Julie Guenoun
- Département de Microbiologie et Infectiologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
| | - François Coutlée
- Département de Microbiologie et Infectiologie, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, QC, Canada
| | - Michel Alary
- Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec—Université Laval, Québec, QC, Canada
- Institut National de Santé Publique du Québec, Québec, QC, Canada
- * E-mail:
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Jongen VW, van Santen DK, Alberts CJ, Schim van der Loeff MF. Estimating incidence rates of grouped HPV types: A systematic review and comparison of the impact of different epidemiological assumptions. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2019; 8:100187. [PMID: 31600572 PMCID: PMC6804437 DOI: 10.1016/j.pvr.2019.100187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Some studies on human papillomavirus (HPV) provide not only type-specific incidence rates (IR), but also IRs of HPV groupings (e.g. the nonavalent grouping). We made an inventory of the different approaches used to calculate such IRs and assessed their impact on the estimated IRs of HPV groupings. METHODS We performed a systematic review assessing all approaches used in literature to estimate IRs. Subsequently we applied these approaches to data of a Dutch cohort study on HPV in men who have sex with men (H2M). IRs were estimated for six different HPV groupings. RESULTS The systematic review yielded six different approaches (A-F) for estimating the IRs, varying in exclusion criteria at baseline, and the definitions of an incident event and person-time. Applying these approaches to the H2M dataset (n = 749), we found differences in the number of participants at risk, number of incidents events, person-time, and IR. For example, for the nonavalent grouping, depending on the approach chosen, the IR varied between 3.09 and 6.54 per 100 person-months. CONCLUSION In published studies different epidemiological assumptions are used to estimate IRs of grouped HPV types, leading to widely differing estimates of IRs. IRs between different studies may therefore not be comparable.
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Affiliation(s)
- Vita W Jongen
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Daniëla K van Santen
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Catharina J Alberts
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; International Agency for Research on Cancer, Lyon, France
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC, Univ of Amsterdam, Internal Medicine, Amsterdam Infection & Immunity Institute (AIII), Amsterdam, Netherlands.
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Diop-Ndiaye H, Beiter K, Gheit T, Sow Ndoye A, Dramé A, McKay-Chopin S, Tommasino M, Bouh Boye CS, Sylla B, Kane CT. Human Papillomavirus infection in senegalese female sex workers. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2019; 7:97-101. [PMID: 30771492 PMCID: PMC6411505 DOI: 10.1016/j.pvr.2019.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 02/04/2019] [Accepted: 02/12/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Several studies have documented the HPV genotypes in the Senegalese general population. The objective was to explore the HPV genotype distribution in Senegalese FSWs in order to assess the potential relevance of currently-available vaccines. METHODS Vaginal swabs samples collected as part of the National Integrated Biological and Behavioral Survey in 14 regions throughout the country were randomly selected for HPV testing using bead-based multiplex genotyping (TS-MPG). RESULTS Among the 436 FSW samples analyzed, the overall HPV prevalence was 79.8% (N = 348), with 70.1% (N = 244) cases presenting as multiple infections. High Risk HPV genotypes affecting at least 10% of FSWs included in order of decreasing frequency: 52, 16, 35, 51, 33, 31, 18, and 45. Sixty-seven (15.4%) FSWs were HIV positive and they were significantly more affected by HPV (94% vs 77%; p < 0.01) than seronegative FSWs as well as infections with multiple genotype. CONCLUSION The present study indicates that FSW in Senegal experience a high burden of HPV infection with a high frequency of coinfection with HIV and multiple HPV genotypes. Public health interventions for this key population should include an earlier cervical dysplasia/cancer detection and preventative measures such as vaccination programs that must consider the HPV genotype distribution.
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Affiliation(s)
| | - Kaylin Beiter
- Bacteriology-Virology Laboratory, CHU Aristide le Dantec, Dakar, Senegal
| | - Tarik Gheit
- Infections and Cancer Biology group, International Agency for Research on Cancer, Lyon, France
| | - Aissatou Sow Ndoye
- Bacteriology-Virology Laboratory, CHU Aristide le Dantec, Dakar, Senegal
| | - Aboubacry Dramé
- Bacteriology-Virology Laboratory, CHU Aristide le Dantec, Dakar, Senegal
| | - Sandrine McKay-Chopin
- Infections and Cancer Biology group, International Agency for Research on Cancer, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology group, International Agency for Research on Cancer, Lyon, France
| | | | - Bakary Sylla
- Infections and Cancer Biology group, International Agency for Research on Cancer, Lyon, France
| | - Coumba Touré Kane
- Bacteriology-Virology Laboratory, CHU Aristide le Dantec, Dakar, Senegal
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Hooi DJ, Quint WGV, Lissenberg-Witte BI, Kenter G, Pinedo HM, de Koning MNC, Meijer CJLM. Human papillomavirus (HPV) types prevalence in cervical samples of female sex-workers on Curaçao. Prev Med Rep 2018; 11:120-124. [PMID: 29992082 PMCID: PMC6038104 DOI: 10.1016/j.pmedr.2018.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 05/06/2018] [Accepted: 06/01/2018] [Indexed: 01/12/2023] Open
Abstract
Sex-workers have an increased risk for high-risk HPV(hrHPV) cervical cancer. On Curaçao, legal and illegal prostitution practice is high and the promiscuous lifestyle is common. We aimed to gain insight in HPV-genotype prevalence in cervical scrapes of female sex workers (FSW) and related risk factors in comparison with women not working in the sex industry. Cervical samples were taken from 76 FSW and 228 non-FSW (NFSW) age matched controls in the period between 2013 and 2015. HPV was detected by GP5+/6+ PCR-EIA followed by genotyping via reverse line-blot. HPV prevalence in FSWs was 25.0% and in NFSWs 29.4% (p = 0.14). NFSW had more often untypable HPV-genotypes (HPV-X:5.3% vs 0.0%; p = 0.042). A trend for statistical difference was observed in HPV prevalence between FSWs from Dominican Republic (42.1%) and FSWs from Colombia (19.2%; p = 0.067). Young age was the only risk factor related to HPV prevalence in FSWs. (Mean age FSW 29.2 y ±7.8 and NFSW 33 y ±6.2) Smoking and drugs consumption were significantly higher among FSW. A significant higher number of women with history of any STD was reported by NFSWs. In addition, >90% of FSW had their previous Pap smear <3 years ago, while >35% NFSW never had a previous Pap smear (p < 0.001). IN CONCLUSION no significant difference in HPV prevalence is observed between FSW and NFSW. HPV prevalence in FSW was associated with a lower age. During interviews, FSW seemed more aware about prevention strategies, reported less history of STD's and were more updated with cervical cancer screening, compared to NFSWs.
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Affiliation(s)
- Desiree J Hooi
- VU University Medical Centre, Department of Pathology, the Netherlands
| | - Wim G V Quint
- DDL Diagnostic Laboratory, Rijswijk, the Netherlands
| | | | - Gemma Kenter
- VU University Medical Centre, Department of Gynaecology and Oncology, the Netherlands
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Epidemiology of HPV Genotypes among HIV Positive Women in Kenya: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0163965. [PMID: 27764092 PMCID: PMC5072621 DOI: 10.1371/journal.pone.0163965] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 09/16/2016] [Indexed: 12/04/2022] Open
Abstract
Background There is a scarcity of data on the distribution of human papillomavirus (HPV) genotypes in the HIV positive population and in invasive cervical cancer (ICC) in Kenya. This may be different from genotypes found in abnormal cytology. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18, and the nonavalent vaccine targeting 90% of all ICC cases, such HPV genotype distribution data are indispensable for predicting the impact of vaccination and HPV screening on prevention. Even with a successful vaccination program, vaccinated women will still require screening to detect those who will develop ICC from other High risk (HR) HPV genotypes not prevented by current vaccines. The aim of this review is to report on the prevalence of pHR/HR HPV types and multiple pHR/HR HPV genotypes in Kenya among HIV positive women with normal, abnormal cytology and ICC. Methods PUBMED, EMBASE, SCOPUS, and PROQUEST were searched for articles on HPV infection up to August 2nd 2016. Search terms were HIV, HPV, Cervical Cancer, Incidence or Prevalence, and Kenya. Results The 13 studies included yielded a total of 2116 HIV-infected women, of which 89 had ICC. The overall prevalence of pHR/HR HPV genotypes among HIV-infected women was 64% (95%CI: 50%-77%). There was a borderline significant difference in the prevalence of pHR/HR HPV genotypes between Female Sex workers (FSW) compared to non-FSW in women with both normal and abnormal cytology. Multiple pHR/HR HPV genotypes were highly prominent in both normal cytology/HSIL and ICC. The most prevalent HR HPV genotypes in women with abnormal cytology were HPV 16 with 26%, (95%CI: 23.0%-30.0%) followed by HPV 35 and 52, with 21% (95%CI: 18%-25%) and 18% (95%CI: 15%-21%), respectively. In women with ICC, the most prevalent HPV genotypes were HPV 16 (37%; 95%CI: 28%-47%) and HPV 18 (24%; 95%CI: 16%-33%). Conclusion HPV 16/18 gains prominence as the severity of cervical disease increases, with HPV 16/18 accounting for 61% (95%CI: 50.0%-70.0%) of all ICC cases. A secondary prevention program will be necessary as this population harbors multiple pHR/HR HPV co-infections, which may not be covered by current vaccines. A triage based on FSW as an indicator may be warranted.
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The Role of Chlamydia trachomatis in High-Risk Human Papillomavirus Persistence Among Female Sex Workers in Nairobi, Kenya. Sex Transm Dis 2016; 42:305-11. [PMID: 25970306 DOI: 10.1097/olq.0000000000000287] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Little is known about risk factors for persistent high-risk human papillomavirus (hrHPV) infection in low-income settings, and prior research has not quantified the relative duration of hrHPV infections stratified by risk factors. We compared the duration of hrHPV infection among female sex workers (FSWs) by exposure to sexually transmitted infections (STIs), using a highly sensitive biomarker assay. METHODS From 2009 to 2011, 350 FSWs enrolled in this longitudinal study. Every 3 months, sociodemographic and sexual behavior data were collected via questionnaire, and APTIMA assays were used to detect the rRNA of Chlamydia trachomatis (CT), Neisseria gonorrhea, Trichomonas vaginalis, Mycoplasma genitalium, and messenger RNA of the E6/E7 oncoproteins expressed by hrHPV. Among 173 FSW who were infected with hrHPV during the observation period, accelerated failure time models estimated time ratios (TRs) for duration of hrHPV infection, comparing FSW infected with STIs at baseline to STI-uninfected FSWs. RESULTS Median follow-up time was 26.2 months (interquartile range, 18.8-27.5 months). The median duration of hrHPV infection among all FSWs was 9.3 months (95% confidence interval [CI], 9.3-11.5). The duration of hrHPV infection among FSW infected with CT at baseline was greater than that among FSWs who were uninfected (adjusted TR, 1.7; 95% CI, 1.2-2.6). Among FSWs who were coinfected with hrHPV and CT at baseline, the adjusted TR was 3.4 (95% CI, 2.5-5.4) compared with FSWs infected with hrHPV only. No other STI was associated with hrHPV duration. CONCLUSIONS Recent or concurrent CT infection was associated with prolonged hrHPV infection among a cohort of Nairobi FSWs. Management of CT could reduce risk for hrHPV persistence.
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