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Unique Human Papillomavirus–Type Distribution in South African Women With Invasive Cervical Cancer and the Effect of Human Immunodeficiency Virus Infection
  1. Matthys Cornelis van Aardt, FCOG(SA)*,
  2. Greta Dreyer, PhD*,
  3. Hannelie Francina Pienaar, FCOG(SA)*,
  4. Frank Karlsen, PhD,
  5. Siri Hovland, Cand. Scient,
  6. Karin Louise Richter, FC Path(SA) Viro§ and
  7. Piet Becker, PhD
  1. *Gynaecologic Oncology Unit, Department of Obstetrics& Gynaecology, University of Pretoria, Pretoria, South Africa;
  2. Buskerud and Vestfold University College, Borre;
  3. NorChip AS, Klokkarstua, Norway;
  4. §Department of Medical Virology University of Pretoria; National Health Laboratory Service; and
  5. Biostatistics Unit, South African Medical Research Council, Departments of Medical Virology, and Gynaecology, University of Pretoria, Pretoria, South Africa.
  1. Address correspondence and reprint requests to Matthys Cornelis van Aardt, FCOG(SA), Department of Obstetrics and Gynaecology, Steve Biko Academic Hospital, Dr Savage Rd, Pretoria 0001, South Africa. E-mail: mc@vanaardt.net.

Abstract

Objectives Cervical cancer is the most common cause of cancer-related deaths among South African women. Viral types associated with cervical cancer may differ not only between countries and regions, but possibly also between human immunodeficiency virus (HIV)–infected and noninfected women.

Methods In a population with high HIV prevalence, human papillomavirus (HPV)–type infections detected with DNA analyses were reported in a cohort of 299 women diagnosed with invasive cervical cancer.

Results One hundred fifty-four women tested HIV negative, 77 tested HIV positive, and HIV status was unknown for 68 women. The mean age for HIV-positive women was 41.3 years, and that for HIV-negative women was 55.8 years (P < 0.001). Ninety-two percent of women tested HPV-DNA positive. Human papillomavirus types 16 and/or 18 were present in 62% of HIV-negative women and 65% of HIV-positive women. The 5 most common HPV types in HIV-positive women were, in decreasing frequency, HPV 16, 18, 45, 33, and 58. In HIV-negative women, the most common HPV types were HPV 16, 18, 35, and 45, followed by HPV 33 and 52. Human papillomavirus type 45 was more likely in the HIV positive compared with the HIV negative (odds ratio, 3.07; 95% confidence interval, 1.07–8.77). The HIV-positive women had more multiple high-risk HPV-type infections than did the HIV-negative women (27% vs 8%, P = 0.001).

Conclusions A high number of women in South Africa with cervical cancer are HIV positive. Without viral cross-protection, HPV vaccines should prevent around 65% of cervical cancers in this population. Human papillomavirus type 45 infection is significantly linked to HIV and important for future vaccine developments.

  • Cervical cancer
  • Human papillomavirus
  • Human immunodeficiency virus

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Footnotes

  • The authors declare no conflicts of interest.

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