Human Papillomavirus infection in senegalese female sex workers

Abstract

Objectives: Several studies have documented the HPV genotypes in the Senegalese general population. The objective was to explore the HPV genotype distribution in Senegalese FSWs in order to assess the potential relevance of currently-available vaccines.

Methods: Vaginal swabs samples collected as part of the National Integrated Biological and Behavioral Survey in 14 regions throughout the country were randomly selected for HPV testing using bead-based multiplex genotyping (TS-MPG).

Results: Among the 436 FSW samples analyzed, the overall HPV prevalence was 79.8% (N = 348), with 70.1% (N = 244) cases presenting as multiple infections. High Risk HPV genotypes affecting at least 10% of FSWs included in order of decreasing frequency: 52, 16, 35, 51, 33, 31, 18, and 45. Sixty-seven (15.4%) FSWs were HIV positive and they were significantly more affected by HPV (94% vs 77%; p < 0.01) than seronegative FSWs as well as infections with multiple genotype.

Conclusion: The present study indicates that FSW in Senegal experience a high burden of HPV infection with a high frequency of coinfection with HIV and multiple HPV genotypes. Public health interventions for this key population should include an earlier cervical dysplasia/cancer detection and preventative measures such as vaccination programs that must consider the HPV genotype distribution.

Keywords: Human Papillomavirus; Human immunodeficiency virus female sex worker; Senegal.

Fig. 1

HPV Infection in Senegalese FSW according to age The proportion of FSW within each age range was presented according to their status regarding HPV infection. The proportion of FSW not infected, infected by a single HPV genotype and infected by multiple HPV genotypes are presented in black (Non-infected), in light grey (Single infected) and in hard grey (Multiple co-infections), respectively. Within each age range, the majority of FSWs harbored multiple HPV genotypes.

Fig. 2

HPV multi infection in Senegalese FSWs according to HIV serostatus The proportion of FSW was presented according to the number of HPV genotypes identified from cervical auto-swabs. The number of HPV genotyped varied between 0 and 13. The global proportion of FSW, HIV seronegative FSW and HIV seropositive FSW are presented in black (All FSWs), in light grey (HIV-) and in hard grey (HIV+), respectively.