The interrelation of HIV, cervical human papillomavirus, and neoplasia among antenatal clinic attenders in Tanzania
Mayaud,Philippe; Gill,Dilbinder K.; Weiss,Helen A.; Uledi,Evelyn; Kopwe,Lilian; Todd,James; ka-Gina,Gina; Grosskurth,Heiner; Hayes,Richard; Mabey,David; Lacey,Charles J.
Sexually Transmitted Infections 77(4): 248-254
Publication date: 2001
To determine the prevalence and interrelation ofcervical human papillomavirus (HPV) genotypes, squamous intraepitheliallesions (SIL), HIV, and other reproductive tract infections(RTIs) among urban antenatal clinic attenders in Mwanza, Tanzania.
Genital swabs were collected from 660 pregnant womenand tested for a range of RTIs and for cervical cytology. CervicalHPV-DNA was detected by PCR and genotyped. HIV and syphilisserologies were performed.
HPV prevalence was 34% (209/612 women). Of the 144typeable samples, 83% were high risk (HR-HPV) oncogenic strains(56% HPV 16 related types). SIL was detected in 43 women (7%),with high grade SIL in 3%. There was a high prevalence of HIV(15%), and of any RTI (83%). Genital warts were detected in20 women (3%). HPV infection was associated with some behaviouralfactors (short duration of relationship, single status, notusing condoms) and gonorrhoea. There was no overall associationbetween HPV and HIV (OR=1.02, 95% CI 0.6-1.6), but a non-significanttrend towards a stronger association with HR-HPV in women aged15-19 (OR=2.79, 95% CI 0.8-9.5) and women aged =" src="/math/ge.gif" border=030(OR=3.20, 95% CI 0.7-15). SIL was associated with HPV(OR=3.66, 95% CI 1.9-7.0), but not significantly withHIV (OR=1.54, 95% CI 0.7-3.4). Prevalence of SIL was higheramong women dually positive for HPV/HIV compared to HPV infectiononly (21% v 12%), although this difference was not statisticallysignificant (p=0.17).
HPV infection was highly prevalent in this youngantenatal population. The association of HIV with HR-HPV typesin older women may suggest that the principal HIV/HPV interactionin this population is for HIV to upregulate HPV persistence,leading to subsequent development of SIL.