Associations of Human Papillomavirus (HPV) genotypes with high-grade cervical neoplasia (CIN2+) in a cohort of women living with HIV in Burkina Faso and South Africa

Helen Kelly , Jean Ngou (1) , Admire Chikandiwa , Bernard Sawadogo (2) , Clare Gilham , Tanvier Omar , Olga Lompo (2) , Sylviane Doutre (1) , Nicolas Meda (2) , Helen Weiss , Sinead Delany-Moretlwe , Michel Segondy (1) , Philippe Mayaud (3)

1 Pathogénèse et contrôle des infections chroniques (PCCI)
2 UJZK - Université Joseph Ki-Zerbo [Université de Ouagadougou, Burkina Faso]
3 WITS - University of the Witwatersrand [Johannesburg]

Objective: To describe associations of high-risk human papillomavirus (HR-HPV) with high-grade cervical intraepithelial neoplasia (CIN2+) in women living with HIV (WLHIV) in Burkina Faso (BF) and South Africa (SA). Methods: Prospective cohort of WLHIV attending HIV outpatient clinics and treatment centres. Recruitment was stratified by ART status. Cervical HPV genotyping using INNO-LiPA and histological assessment of 4-quadrant cervical biopsies at enrolment and 16 months later. Results: Among women with CIN2+ at baseline, the prevalence of any HR-HPV genotypes included in the bi/quadrivalent (HPV16/18) or nonavalent (HPV16/18/31/35/45/52/58) HPV vaccines ranged from 37% to 90%. HPV58 was most strongly associated with CIN2+ (aOR = 5.40, 95%CI: 2.77–10.53). At 16-months follow-up, persistence of any HR-HPV was strongly associated with incident CIN2+ (aOR = 7.90, 95%CI: 3.11–20.07), as was persistence of HPV16/18 (aOR = 5.25, 95%CI: 2.14–12.91) and the additional HR types in the nonavalent vaccine (aOR = 3.23, 95%CI: 1.23–8.54). Conclusion: HR-HPV persistence is very common among African WLHIV and is linked to incident CIN2+. HPV vaccines could prevent between 37–90% of CIN2+ among African WLHIV.

Domaines: Santé publique et épidémiologie; Gynécologie et obstétrique; Maladies infectieuses; Cancer

Helen Kelly, Jean Ngou, Admire Chikandiwa, Bernard Sawadogo, Clare Gilham, et al.. Associations of Human Papillomavirus (HPV) genotypes with high-grade cervical neoplasia (CIN2+) in a cohort of women living with HIV in Burkina Faso and South Africa. PLoS ONE, 2017, 12 (3), pp.e0174117. ⟨10.1371/journal.pone.0174117⟩. ⟨hal-01773696⟩