Journal
TROPICAL MEDICINE & INTERNATIONAL HEALTH
Volume 17, Issue 12, Pages 1432-1440Publisher
WILEY
DOI: 10.1111/tmi.12004
Keywords
human papillomavirus; genotype distribution; cervical cancer; HIV; sub-Saharan Africa; Virus du papillome humain; distribution des genotypes; cancer du col de l'uterus; VIH; Afrique subsaharienne; Virus del Papiloma Humano; distribucion de genotipos; cancer cervical; VIH; Africa subsahariana
Funding
- Canadian Institutes of Health Research
- Fonds de Recherche en Sante du Quebec
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Objectives To describe human papillomavirus (HPV) distribution in invasive cervical carcinoma (ICC) from Mali and Senegal and to compare type-specific relative contribution among sub-Saharan African (SSA) countries. Methods A multicentric study was conducted to collect paraffin-embedded blocks of ICC. Polymerase chain reaction, DNA enzyme immunoassay and line probe assay were performed for HPV detection and genotyping. Data from SSA (Mozambique, Nigeria and Uganda) and 35 other countries were compared. Results One hundred and sixty-four ICC cases from Mali and Senegal were tested from which 138 were positive (adjusted prevalence = 86.8%; 95% CI = 79.791.7%). HPV16 and HPV18 accounted for 57.2% of infections and HPV45 for 16.7%. In SSA countries, HPV16 was less frequent than in the rest of the world (49.4%vs. 62.6%; P < 0.0001) but HPV18 and HPV45 were two times more frequent (19.3%vs. 9.4%; P < 0.0001 and 10.3%vs. 5.6%; P < 0.0001, respectively). There was an ecological correlation between HIV prevalence and the increase of HPV18 and the decrease of HPV45 in ICC in SSA (P = 0.037 for both). Conclusion HPV16/18/45 accounted for two-thirds of the HPV types found in invasive cervical cancer in Mali and Senegal. Our results suggest that HIV may play a role in the underlying HPV18 and HPV45 contribution to cervical cancer, but further studies are needed to confirm this correlation.
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