Human Papillomavirus Prevalence in South African Women & Men According to Age & Human Immunodeficiency Virus Status

Both cervical cancer and human immunodeficiency virus (HIV) are major public health problems in Sub-Saharan Africa. The objectives of the study were to investigate human papillomavirus (HPV) prevalence according to age, HIV status and gender.

Participants were 208 HIV-negative women, 278 HIV-positive women, 325 HIV-negative men and 161 HIV-positive men between the ages of 18–66 years. HPV types were determined in cervical and penile cells by Roche Linear Array HPV genotyping assay.

HPV prevalence was 36.7 % (76/207; 95 % confidence intervals (CI): 30.4–43.4 %) in HIV-negative women, with the highest prevalence of 61.0 % (25/41; 95 % CI: 45.7–74.4 %) in women aged 18–25 years. HPV prevalence was 74.0 % (205/277; 95 % CI: 68.5–78.8 %) in HIV-positive women, with the highest prevalence of 86.4 % (38/44; 95 % CI: 72.9–94.0 %) in women aged 18–25 years. HPV prevalence was found to decrease with increasing age in HIV-negative women (P = 0.0007), but not in HIV-positive women (P = 0.898). HPV prevalence was 50.8 % (159/313; 95 % CI: 45.3–56.3 %) in HIV-negative men, with the highest prevalence of 77.0 % (27/35; 95 % CI: 60.7–88.2 %) in men aged 18–25 years. HPV prevalence was 76.6 % (121/158; 95 % CI: 69.2–82.9 %) in HIV-positive men, with the highest prevalence of 87.5 % (7/8; 95 % CI: 50.8–99.9 %) in men 18–25 years of age. HPV prevalence was found to decrease with increasing age in HIV-negative men (P = 0.004), but not in HIV-positive men (P = 0.385). HIV-positive women had a significantly higher prevalence of one or more HPV type(s) in the bivalent (HPV-16/18: 20 % 55/277, 9 % 12/207; P <0.001), quadrivalent (HPV-6/11/16/18: 26 % 71/277, 12 % 24/207; P = 0.001) and nonavalent vaccine (HPV-6/11/16/18/31/33/52/56/58: 65 % 181/277, 24 % 50/207; P<0.001) compared to HIV-negative women. Similar observation were observed in men for bivalent (20 % 32/158, 10 % 30/313; P = 0.001), quadrivalent (35 % 56/158, 13 % 41/313; P <0.001) and nonavalent vaccine (75 % 119/158, 28 % 87/313; P <0.001).

This study demonstrated high HPV prevalence among HIV-positive women and men in all age groups. The high prevalence of HPV types found in bivalent, quadrivalent and nonavalent vaccines in South African HIV-positive and HIV-negative women and men demonstrate that this population will greatly benefit from current HPV vaccines.

Below: Distribution of multiple HPV genotype infections in HIV-positive (a) and HIV-negative (b) women

Below: Distribution of multiple HPV genotype infections in HIV-positive (a) and HIV-negative (b) men

Below: Prevalence of types targeted by bivalent, quadrivalent and nonavalent HPV vaccines in women and men according to HIV status

Full article at: http://goo.gl/8sZj10

By: Zizipho Z A Mbulawa¹², David Coetzee³ and Anna-Lise Williamson^145*

¹Institute of Infectious Disease and Molecular Medicine and Division of Medical Virology, University of Cape Town, Anzio Road, Observatory, Cape Town, 7925, South Africa

²Center for HIV and STIs, National Institute for Communicable Disease, National Health Laboratory Service, Cape Town, South Africa

³Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa

⁴SAMRC Gynaecological Cancer Centre, University of Cape Town, Cape Town, South Africa

⁵National Health Laboratory Service, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa

   

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