High Prevalence of High-Risk Human Papillomavirus Genotypes Other Than HPV-16 and HPV-18 in Congolese Women Living With HIV: Implication for Cervical Cancer Prevention in a Resource Limited Setting
DOI:
https://doi.org/10.47363/JVRR/2023(4)158Keywords:
High-Risk Human Papillomavirus Genotypes, HPV16, HPV-18, Cervical Cancer, CD4 T Cells Count, HIV RNA Load, Women Living With HIVAbstract
Background: Despite the undeniable benefits provided by antiretroviral therapy (ART) in drastically reducing AIDS-related mortality, women living with HIV (WLWH) are disproportionately affected by high-risk Human Papillomavirus (HR-HPV) infection and cervical cancer. We herein assessed the distribution of HR-HPV genotypes according to HIV immunovirological prognostic parameters and their implications for the prevention of cervical cancer.
Methods: Among 276 screened WLWH on ART attending the HIV outpatient treatment clinic in Brazzaville, in the Republic of Congo, 122 tested positive for HR-HPV (mean age: 43.92 ± 9.98 years) were included in a cross-sectional study. Sociodemographic and clinical information were collected and CD4+ T cells count and HIV RNA load were determined. HR-HPV genotypes distribution was determined from cervicovaginal samples using the ABBOTT Real Time High Risk HPV kit (Abbott, Chicago, USA).
Results: A total of 122 (44.4%) WLWH were tested positive for any-HR-HPV, including 73.8% of HR-HPV genotypes other than HPV-16/HPV-18, while HPV-16 (14.7%) and HPV-18 (11.5%) were less frequently detected. Overall, nor CD4+ T cells count, HIV-1 RNA load or the duration of HIV diagnosis did have a significant impact in the distribution of HR-HPV genotypes in WLWH positive for cervical HR-HPV infection. However, around half of all HPV-16 infections occurred in women with the highest CD4+ T cells count (≥500 CD4+ T cells/μL). On the other hand, women with lower CD4+ T cells count (200 to 349 cells/μL) were more likely to carry HPV-18 DNA and HR-HPV genotypes other than HPV-16.
Conclusion: WLWH in Brazzaville in the Republic of Congo are largely infected by HR-HPV genotypes other than HPV-16 and HPV-18, suggesting a possible reduced predictive efficacy of HPV vaccine in this population. A secondary prevention with a regular screening for cervical pre-cancerous lesions should be prioritized in WLWH living in Brazzaville, in the Republic of Congo.
