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. 2017 Oct 16;17(1):688.
doi: 10.1186/s12885-017-3682-x.

Epidemiology of cervical human papillomavirus (HPV) infection and squamous intraepithelial lesions (SIL) among a cohort of HIV-infected and uninfected Ghanaian women

Dorcas Obiri-Yeboah  1 , Patrick K Akakpo  2 , Mohamed Mutocheluh  3 , Emmanuel Adjei-Danso  4 , Gloria Allornuvor  5 , Daniel Amoako-Sakyi  6 , Yaw Adu-Sarkodie  3 , Philippe Mayaud  7
Affiliations

Epidemiology of cervical human papillomavirus (HPV) infection and squamous intraepithelial lesions (SIL) among a cohort of HIV-infected and uninfected Ghanaian women

Dorcas Obiri-Yeboah et al. BMC Cancer. .

Abstract

Background: There is limited data in Ghana on the epidemiology of HPV and cervical neoplasia and their associations with HIV. This study aimed to compare among HIV-1 seropositive and HIV-seronegative Ghanaian women: (1) the prevalence, genotype distribution and risk factors associated with cervical HPV infection; and (2) the prevalence and risk factors associated with abnormal cervical cytology.

Methods: A comparative frequency-matched study was conducted in a systematic sample of women aged ≥18 years attending HIV and general outpatient clinics in Cape Coast Teaching Hospital, Ghana. Participants were interviewed and cervical samples collected for HPV genotyping (Seegene Anyplex-II HPV28) and cytological testing.

Results: Overall, 333 women were recruited, 163 HIV-1 seropositive and 170 HIV-seronegative women of mean age 43.8 years (SD ±9.4)) and 44.3 years (SD ±12.8), respectively. The prevalence of 14 high-risk (hr) HPV genotypes was higher among HIV-1 seropositive women (65.6% vs. 30.2%, P < 0.0001), as was proportion with multiple hr.-HPV infections (60.6% vs. 21.3%, P < 0.0001). HPV35 was the most prevalent hr.-HPV genotype in both groups (11.9% and 5.3%). The main factors associated with hr.-HPV infection were age for HIV-positive women and circumcision status of main sexual partner for both HIV-negative and positive women. Abnormal cervical cytology prevalence was higher among HIV-1 seropositive women (any SIL: 14.1% vs. 1.2%, P < 0.0001; low-grade SIL [LSIL]: 4.9% vs. 0.6%, P = 0.02; high-grade SIL: 1.8% vs. 0%, P = 0.07). Among HIV-1 seropositive women, number of pregnancies and CD4+ cell count were associated with LSIL+ cytology. There was strong association between LSIL+ abnormalities and HPV35 (aOR = 4.7, 95%CI: 1.3-17.7, P = 0.02).

Conclusions: HIV-1 infected women bear significant burden of HPV infection and related disease. Prevention and screening programmes should be specifically deployed for this population in Ghana.

Keywords: Cervical cancer; Genotyping; Ghana; Human immunodeficiency virus (HIV); Human papillomavirus (HPV); Squamous intraepithelial lesions (SIL).

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Conflict of interest statement

Ethics approval and consent to participate

Ethical approval was obtained from the Committee on Human Research Publications and Ethics (CHRPE) of the School of Medical Sciences (SMS), Kwame Nkrumah University of Science and Technology (KNUST). Study participants signed or thumb printed written informed consent indicating consent to participate.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interest be it financial or non-financial.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
High-risk HPV genotypes prevalence by cytological category, for HIV-1 seropositive women (N = 163). Figure legend: ASCUS = Atypical Squamous Cells of Undetermined Significance, LSIL = Low Grade Squamous Intraepithelial Lesions, HSIL = High Grade Squamous Intraepithelial Lesions
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