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Trop Med Int Health. 2012 Dec;17(12):1432-40. doi: 10.1111/tmi.12004. Epub 2012 Oct 29.

Human papillomavirus distribution in invasive cervical carcinoma in sub-Saharan Africa: could HIV explain the differences?

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  • 1Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada  Sainte-Justine Hospital Research Center, Montreal, QC, Canada  Unit of Infections and Cancer, Institut Català d'Oncologia, Barcelona, Spain  CIBER Epidemiología y Salud Pública, CIBERESP, Barcelona, Spain  Université Cheikh Anta Diop, Dakar, Senegal  Faculté de Médecine, Université de Bamako, Bamako, Mali  Hôpital Principal de Dakar, Dakar, Senegal  Department of Pathology, School of Biomedical Sciences, Makerere University, Kampala, Uganda  Lagos University Teaching Hospital Idi-Araba, Lagos, Nigeria  Red Temàtica de Investigaciòn Cooperativa en Càncer, RTICC, Barcelona, Spain.

Abstract

OBJECTIVES:

To describe human papillomavirus (HPV) distribution in invasive cervical carcinoma (ICC) from Mali and Senegal and to compare type-specific relative contribution among sub-Saharan African (SSA) countries.

METHODS:

A multicentric study was conducted to collect paraffin-embedded blocks of ICC. Polymerase chain reaction, DNA enzyme immunoassay and line probe assay were performed for HPV detection and genotyping. Data from SSA (Mozambique, Nigeria and Uganda) and 35 other countries were compared.

RESULTS:

One hundred and sixty-four ICC cases from Mali and Senegal were tested from which 138 were positive (adjusted prevalence = 86.8%; 95% CI = 79.7-91.7%). HPV16 and HPV18 accounted for 57.2% of infections and HPV45 for 16.7%. In SSA countries, HPV16 was less frequent than in the rest of the world (49.4%vs. 62.6%; P < 0.0001) but HPV18 and HPV45 were two times more frequent (19.3%vs. 9.4%; P < 0.0001 and 10.3%vs. 5.6%; P < 0.0001, respectively). There was an ecological correlation between HIV prevalence and the increase of HPV18 and the decrease of HPV45 in ICC in SSA (P = 0.037 for both).

CONCLUSION:

HPV16/18/45 accounted for two-thirds of the HPV types found in invasive cervical cancer in Mali and Senegal. Our results suggest that HIV may play a role in the underlying HPV18 and HPV45 contribution to cervical cancer, but further studies are needed to confirm this correlation.

© 2012 Blackwell Publishing Ltd.

KEYWORDS:

Afrique subsaharienne; HIV; VIH; Virus del Papiloma Humano; Virus du papillome humain; cancer du col de l’utérus; cervical cancer; cáncer cervical; distribución de genotipos; distribution des génotypes; genotype distribution; human papillomavirus; sub‐Saharan Africa; África subsahariana

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