Human papillomavirus (HPV)-type distribution in relation to oral contraceptive use in women with cervical intraepithelial neoplasia, Durban, South Africa

Abstract

Objective: To determine HPV-type distribution among women with cervical dysplasia in relation to oral contraceptive usage.

Methods: Prospective cross-sectional study of four groups of patients according to oral contraceptive usage: non-users, users of less than five years duration, users of between five years and ten years, and users of more than ten years duration. Swabs of the cervix were analysed for HPV DNA using the polymerase chain reaction method.

Results: A total of 124 women were recruited for the study. There were 75 patients who were HIV-infected (seroprevalence 61%). There were 102 patients who were HPV positive (82%), of which 79 patients had high-risk HPV DNA (78%). In terms of the four oral contraceptive groups, high-risk HPV DNA was detected in 70% (n = 21), 79% (n = 22), 90% (n = 21) and 71% (n = 15) of patient, respectively. The odds of having HPV DNA was six times higher for the combination of contraceptive users of less than five years duration/non-users (OR 5.9, 95% CI: 1.87-18.77). There was no change when adjustment was made for age (OR 6.1, 95% CI: 1.9-19.4). HPV DNA type 16 and/or 18 was present in a total of 21 patients (49%) (non-contraceptive users and users < 5 years duration) versus 15 patients (42%) (oral contraceptive users of more than 5 years duration) (p = 0.524). HPV type 16 was the commonest HPV type detected (20.2%) and HPV type 58 was the next commonest hihg-risk HPV type (16.1%). HPV types 58 and 33 were detected in a much greater percentage of our population and HPV 16 in a much smaller percentage of our population compared with a non-South African population.

Conclusion: The findings of this study demonstrate an interesting distribution of HPV types in a South African population.