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Oncogenic and incidental HPV types associated with histologically confirmed cervical intraepithelial neoplasia in HIV-positive and HIV-negative South African women

Matthys Cornelis van Aardt, Greta Dreyer, Leon Cornelius Snyman, Karin Louise Richter, Piet Becker, Sebolelo Mpho Mojaki

Abstract


Background. In Africa, data on the relationship between oncogenic human papillomavirus (HPV) types, immune status and cervical preinvasive lesions are lacking.

Methods. We investigated low-risk (lrHPV) and high-risk (hrHPV) HPV types in a cohort of women with cervical intraepithelial neoplasia (CIN) II/III confirmed on histological examination, in an urban setting with a high prevalence of HIV infection.

Results. Of 270 women with confirmed CIN II/III, 45 were HIV-negative and 225 HIV-positive. HIV-infected women had significantly more HPV type infections, including all HPV (p<0.001) and hrHPV (p=0.014) types. The prevalences of one or more hrHPV type/s were 93.3% and 92.9% in HIV-negative and positive patients, respectively. The most prevalent hrHPV type among HIV-negative women was HPV 16, followed by HPV 52, 31, 35 and 58. Among HIV-positive women, HPV 16 was followed by HPV 58, 35, 51 and 52. Not yet qualifying qualify for highly active antiretroviral therapy (HAART) (CD4 count >350 cells/μL) or having received HAART for ≥12 months were negatively associated with HPV 18, 33, 45, 51, 52, 59 and 82.

Conclusions. In South Africa, burdened by the HIV pandemic, high numbers of high- and low-risk HPV type infections are present in women with cervical preneoplasia. HPV type distribution differs among varying levels of HIV-induced immune depletion.


Authors' affiliations

Matthys Cornelis van Aardt, Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

Greta Dreyer, Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

Leon Cornelius Snyman, Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

Karin Louise Richter, Department of Medical Virology, School of Medicine, Faculty of Health Sciences, University of Pretoria; National Health Laboratory Service, Pretoria, South Africa

Piet Becker, Biostatistics Unit, South African Medical Research Council, Pretoria

Sebolelo Mpho Mojaki, Gynaecological Oncology Unit, Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

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Keywords

Human papillomavirus; Cervical intraepithelial neoplasia; Human immunodeficiency virus

Cite this article

South African Medical Journal 2016;106(6):617-622. DOI:10.7196/SAMJ.2016.v106i6.10335

Article History

Date submitted: 2015-11-10
Date published: 2016-05-11

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