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J Med Virol. 2017 Sep;89(9):1671-1677. doi: 10.1002/jmv.24825. Epub 2017 Jun 15.

Genotypic diversity of anogenital human papillomavirus in women attending cervical cancer screening in Harare, Zimbabwe.

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Department of Medical Microbiology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Microbiology and Infection Control, Akershus University Hospital, Lørenskog, Norway.
Department of Immunology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Community Medicine, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Research, Cancer Registry of Norway, Oslo, Norway.
Department of Medicine, University of California, San Francisco, California.
Women's Clinic, Rikshospitalet, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Obstetrics and Gynaecology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.


Although anogenital cancers have been on a gradual rise in developing countries in the past few decades, they have been understudied. The objective was to investigate genotypic diversity of anogenital HPV amongst women reporting for routine cervical cancer screening in Harare in Zimbabwe. A cross-sectional study that enrolled 144 women ≥18 years from a cervical cancer-screening clinic was performed. Each woman provided a self-collected cervico-vaginal swab (VS) and a clinician-collected anal swab (CCAS). HIV testing was offered and cervical cytology was performed. Both VS and CCAS samples were HPV genotyped, using amplicon sequencing of the L1 gene region with Illumina technology. Mean age of the women was 39.9 (range 18-83 years, SD ± 11.0). HPV prevalence was 72% (104/144) in VS and 48% (69/144) in CCAS. The most common genotypes detected in both VS and CCAS were HPV18, HPV52, and HPV16. Sixty two percent of the subjects had multiple genotypic HPV infections. The odds of being HPV-positive among HIV-infected women were higher than in HIV-negative women in both the vagina and the anus (CCAS OR = 4.8; CI 2.4-9.8, P < 0.001) and (VS OR = 2.9; CI 1.3-6.4, P = 0.005). High HPV prevalence and diverse genotypes were detected in both the vagina and anus. Anal oncogenic HPV infection was common. HPV 52 was one of the most common oncogenic genotypes in both the vagina and anus. HIV co-infection played a significant role in the prevalence of HPV. These data have implications for design of primary and secondary programs for prevention of anogenital cancer in Zimbabwe.


Zimbabwe; anogenital; genotypes; human papillomavirus; sequencing; women

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