感染症と治療ジャーナル

抽象的な

Human Papillomavirus Genotypes in Invasive Cervical Carcinoma in HIV Seropositive and Seronegative Women in Zimbabwe

Washington Muodini, Joael Michael Palefnsky, Martin John Hale, Michael Zvavahera Chirenje, Rudo Tanyaradzwa Makunike-Mutasa, Fiona Mutisi, Alltalents Murahwa and Mario Altini

Background: Invasive cervical carcinoma (ICC) accounts for 23% of all cancer-related deaths in Zimbabwean women. Trials for a national program of genotype-specific HPV vaccines are underway to prevent cervical carcinoma, but the distribution of HPV types among women with ICC according to HIV status is unknown.
Methods: To determine prevalence and distribution of high-risk HPV genotypes by HIV status in women with ICC, we performed a cross-sectional study on women referred for ICC testing at four urban referral hospitals in Zimbabwe from June 2014-December 2015. Cervical biopsies were obtained for histology and HPV genotyping. HIV serology testing was performed. HPV testing was performed using MY09/MY11 PCR followed by typing using dot blot hybridization.
Results: Of 107 participants with histologically-proven, HIV prevalence was 49.5% (53/107). HIV-positive women tended to be younger (median age 44 years) than HIV-negative women (median age 59 years). HPV prevalence was 94% (101/107), ranging from 1-5 genotypes per participant. HPV 16 (81.5%), 18 (24%), 33 (13%), 35 (11%), 56 (9%) and 45(7.4%) were the most prevalent genotypes amongst HIV-negative participants; HPV 16 (67.9%), 18 (43.4%), 56 (18.9%), 45 (15.1%), 33 (11.3%), and 58 (9.4%) were most prevalent amongst HIV-positive participants. 83% of women were infected with either HPV-16 or HPV-18.
Conclusion: Effective vaccination programs against HPV 16 and 18 could prevent up to 83% of cases of cervical cancer in Zimbabwe. HIV may influence distribution of some HPV genotypes given the significant increase in prevalence of HPV 18 amongst HIV positive participants.