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Mcharo, R.* ; Lennemann, T.* ; France, J.* ; Torres, L.* ; Garí, M. ; Mbuya, W.* ; Mwalongo, W.* ; Mahenge, A.* ; Bauer, A.J.* ; Mnkai, J.* ; Glasmeyer, L.* ; Judick, M.* ; Paul, M.* ; Schroeder, N.* ; Msomba, B.* ; Sembo, M.* ; Chiwerengo, N.* ; Hoelscher, M.* ; Geisenberger, O.* ; Lelle, R.J.* ; Saathoff, E.* ; Maboko, L.* ; Chachage, M.* ; Kroidl, A.* ; Geldmacher, C.*

HPV type distribution in HIV positive and negative women with or without cervical dysplasia or cancer in East Africa.

Front. Oncol. 11:763717 (2021)

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Background: Women living with HIV in sub-Saharan Africa are at increased risk to develop cervical cancer (CC), which is caused by persistent infection with 13 oncogenic human papilloma viruses (HR-HPVs). It is important to accurately identify and target HIV-positive women at highest risk to develop CC for early therapeutic intervention. Methods: A total of 2,134 HIV+ and HIV− women from South-West Tanzania were prospectively screened for cervical cancer and precancerous lesions. Women with cervical cancer (n=236), high- and low-grade squamous intraepithelial lesions (HSIL: n=68, LSIL: n=74), and without lesion (n=426) underwent high-resolution HPV genotyping. Results: Eighty percent of women who were diagnosed with HSIL or LSIL were living with HIV. Any lesion, young age, HIV status, and depleted CD4 T cell counts were independent risk factors for HPV infections, which were predominantly caused by HR-HPV types. While multiple HR-HPV type infections were predominant in HIV+ women with HSIL, single-type infections predominated in HIV+ CC cases (p=0.0006). HPV16, 18, and 45 accounted for 85% (68/80) and 75% (82/110) of HIV+ and HIV− CC cases, respectively. Of note, HPV35, the most frequent HPV type in HSIL-positive women living with HIV, was rarely detected as a single-type infection in HSIL and cancer cases. Conclusion: HPV16, 18, and 45 should receive special attention for molecular diagnostic algorithms during CC prevention programs for HIV+ women from sub-Saharan Africa. HPV35 may have a high potential to induce HSIL in women living with HIV, but less potential to cause cervical cancer in single-type infections.

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