High-risk human papillomavirus types in HIV-infected and HIV-uninfected young women in KwaZulu-Natal, South Africa: implications for vaccination

Abstract

Background: High-risk human papillomavirus (hr-HPV) infections and low-grade squamous intraepithelial lesions occur frequently in young women. The available vaccines cover up to seven hr-HPV genotypes (HPV16, HPV18, HPV31, HPV33, HPV45, HPV52 and HPV58) and two low-risk HPV types (HPV6 and HPV11). The objective of this study was to describe the hr-HPV genotypes present among HIV-uninfected and HIV-infected young women in rural high schools.

Methods: Cervicovaginal lavages were obtained from sexually active young women recruited from high schools in KwaZulu-Natal (n = 1223). HPV testing was done by the polymerase chain reaction using GP5+/GP6 + primers and enzyme immunoassay. HIV testing was done using rapid test kits.

Results: Of the 1223 cervicovaginal lavages, 301 (25%) were positive for hr-HPV. The HPV prevalence was higher in HIV infected (32.20%, 95% CI: 0.27–0.38) than in HIV-uninfected women (22.50%, 95% CI: 0.21–0.26), (p = .001). Similarly, multiple infections were slightly more common in HIV infected (59.32%) than in HIV-uninfected women (53.51%), (p = .37). The nine predominant genotypes in descending order were HPV types 16 (n = 99, 22.10%), 51 (n = 58, 12.91%), 18 (n = 56, 12.50%), 35 (n = 50, 11.10%), 33 (n = 47, 10.82%), 56 (n = 42, 9.31%), 45 (n = 34, 7.60%), 52 (n = 32, 7.14%) and 59 (n = 31, 6.91%). HPV 35, 51, 56 and 59 (40.62%), which are not covered by any vaccine, were among the most prevalent in the schools of KwaZulu-Natal.

Conclusion: Four of the most predominant high-risk HPV types in this region are not covered by the new nine-valent HPV vaccine.

Keywords:

• Human papillomavirus
• cervical cancer
• human immunodeficiency virus

View correction statement:

Correction to: Mbatha et al., High-risk human papillomavirus types in HIV-infected and HIV-uninfected young women in KwaZulu-Natal, South Africa: implications for vaccination

Correction to: Mbatha et al., High-risk human papillomavirus types in HIV-infected and HIV-uninfected young women in KwaZulu-Natal, South Africa: implications for vaccination

Acknowledgements

We thank the following organizations and individuals without whom this study would not have been possible:

The BRIGHT study team for support, assistance and guidance of the study participants.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

The research leading to the results discussed in this manuscript received funding from the: South-Eastern Regional Health Authority, Norway project no. 2014065. Norwegian Research Council ref 213702/H10. European Research Council under the European Union Seventh Framework Programme (FP7/2007-2013)/ERC Grant agreement no. PIRSES-GA-2010-269245. The University of KwaZulu-Natal’s College of Health Sciences and the SAMRC partly funded the project. The funding bodies had no contribution in the study design, collection and analysis of data nor in developing the manuscript.