Variability of high risk HPV genotypes among HIV infected women in Mwanza, Tanzania- the need for evaluation of current vaccine effectiveness in developing countries

doi:10.1186/s13027-016-0097-2

. 2016 Aug 19:11:49.

doi: 10.1186/s13027-016-0097-2. eCollection 2016.

Variability of high risk HPV genotypes among HIV infected women in Mwanza, Tanzania- the need for evaluation of current vaccine effectiveness in developing countries

Fridolin Mujuni¹, Mariam M Mirambo², Peter Rambau³, Korn Klaus⁴, Muller Andreas⁵, Dismas Matovelo¹, Mtebe Majigo⁶, Christa Kasang⁵, Stephen E Mshana²

Affiliations

¹ Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
² Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
³ Department of Pathology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
⁴ Institute of Clinical and Molecular Virology, Enlargen University, Schlossgarten 4, 91054 Erlangen, Germany.
⁵ Medical Mission Institute, Salvatorstrasse 7, 97067 Wuerzburg, Germany.
⁶ Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.

PMID: 27547239
PMCID: PMC4991109
DOI: 10.1186/s13027-016-0097-2

Variability of high risk HPV genotypes among HIV infected women in Mwanza, Tanzania- the need for evaluation of current vaccine effectiveness in developing countries

Fridolin Mujuni et al. Infect Agent Cancer. 2016.

. 2016 Aug 19:11:49.

doi: 10.1186/s13027-016-0097-2. eCollection 2016.

Authors

Fridolin Mujuni¹, Mariam M Mirambo², Peter Rambau³, Korn Klaus⁴, Muller Andreas⁵, Dismas Matovelo¹, Mtebe Majigo⁶, Christa Kasang⁵, Stephen E Mshana²

Affiliations

¹ Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
² Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
³ Department of Pathology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
⁴ Institute of Clinical and Molecular Virology, Enlargen University, Schlossgarten 4, 91054 Erlangen, Germany.
⁵ Medical Mission Institute, Salvatorstrasse 7, 97067 Wuerzburg, Germany.
⁶ Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.

PMID: 27547239
PMCID: PMC4991109
DOI: 10.1186/s13027-016-0097-2

Abstract

Background: High risk (HR) human papilloma Virus (HPV) genotypes have been associated with cervical cancer. In Tanzania there is a limited data on the epidemiology of HPV and genotypes distribution among HIV infected women. Here we document varieties of HPV genotypes associated with cervical squamous intraepithelial lesions (SIL) among HIV- infected women at Bugando Medical Centre, Mwanza-Tanzania.

Methods: A cross sectional hospital based study involving HIV infected women was conducted between August and October, 2014. Exfoliated cells from ectocervix and endocervix were collected using cytobrush. HPV genotypes were detected using polymerase chain reaction (PCR) followed by sequencing using specific primers targeting broad range of HPV types. Cytology was done to establish squamous intraepithelial lesions. Log binomial regression analysis was done to establish risk ratios (RR) associated with HPV infection using STATA version 11.

Results: A total of 255 HIV infected women with mean age 39.2 ± 9.1 years were enrolled in the study. HPV DNA was detected in 138/255 (54.1 %, 95 % CI: 47-60) of HIV infected women. Twenty six genotypes were detected in various combinations; of these 17(65.3 %) were of HR genotypes. HR genotypes were detected in 124(48.6 %) of HIV infected women. Common HR genotypes detected were HPV-52(26), HPV-58(21), HPV-35(20) and HPV-16(14). The risk of being HPV positive was significantly higher among women with CD4 counts <100 (RR: 1.20, 95 % CI: 1.05-1.35, P = 0.006) and women with SIL (RR: 1.37, 95 % CI: 1.11-1.68, P = 0.005).

Conclusion: Significant proportion of HIV infected women with low CD4 counts have various grades of cervical SIL associated with varieties of uncommon HR genotypes. There is a need to evaluate the effectiveness of the current vaccine in preventing cervical cancer in developing countries where HIV is endemic.

Keywords: HIV; HPV; High risk genotypes; Mwanza.

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Figures

**Fig. 1**
High risk and low risk HPV genotypes in relation to cervical squamous intraepithelial lesions

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References

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[1] Cox JT. Epidemiology and natural history of HPV. J Fam Pract. 2006;21:3–9. - PubMed

[2] Cox JT. Epidemiology and natural history of HPV. J Fam Pract. 2006;21:3–9. - PubMed

[3] WHO: ICO HPV Information Centre. WHO/ICO information Centre on Human Papilloma Virus (HPV) and cervical Cancer centre. 2010.

[4] WHO: ICO HPV Information Centre. WHO/ICO information Centre on Human Papilloma Virus (HPV) and cervical Cancer centre. 2010.

[5] Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108. doi: 10.3322/canjclin.55.2.74. - DOI - PubMed

[6] Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74–108. doi: 10.3322/canjclin.55.2.74. - DOI - PubMed

[7] Castellsague X, de Sanjose S, Aguado T: HPV and Cervical Cancer in The World, 2007 Report. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Geneva: WHO; Barcelona: ICO. In.; 2010

[8] Castellsague X, de Sanjose S, Aguado T: HPV and Cervical Cancer in The World, 2007 Report. WHO/ICO Information Centre on HPV and Cervical Cancer (HPV Information Centre). Geneva: WHO; Barcelona: ICO. In.; 2010

[9] Clifford GM, Goncalves MAG, Franceschi S, HPV, group Hs Human papillomavirus types among women infected with HIV: a meta-analysis. Aids. 2006;20(18):2337–2344. doi: 10.1097/01.aids.0000253361.63578.14. - DOI - PubMed

[10] Clifford GM, Goncalves MAG, Franceschi S, HPV, group Hs Human papillomavirus types among women infected with HIV: a meta-analysis. Aids. 2006;20(18):2337–2344. doi: 10.1097/01.aids.0000253361.63578.14. - DOI - PubMed

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Variability of high risk HPV genotypes among HIV infected women in Mwanza, Tanzania- the need for evaluation of current vaccine effectiveness in developing countries

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Variability of high risk HPV genotypes among HIV infected women in Mwanza, Tanzania- the need for evaluation of current vaccine effectiveness in developing countries

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