HPV Prevalence in HIV Infected and Healthy Rwandan Women

Abstract

Abstract Degree project, Programme in Medicine HPV Prevalence in HIV infected and Healthy Rwandan Women Hanna Erlandsson, University of Gothenburg, Sweden 2016 Supervisors: Daniel Giglio and Marie Francoise Mukanyangezi Background Cervical cancer is the leading cause of cancer death among women in Rwanda, thus making it essential to map out the prevalence of different human papillomavirus (HPV) types. Mass vaccination programs of school girls have been enrolled in Rwanda covering HPV16 and HPV18. In Sweden, HPV16 and HPV 18 stand for 70 % of all cervical cancers. In Rwanda, the prevalence of HPV strains in the population is not known. Here we assessed the prevalence of different HPV strains in HIV patients and a healthy control group of patients in Rwanda. Aim To assess the prevalence of HPV infection in healthy and HIV infected women in Rwanda. Methods Cervical specimens and data were obtained from 200 healthy and 200 HIV-infected Rwandan women. The prevalence of different HPV strains among the study participants was analysed. The patients were tested for 39 different HPV strains. Results The prevalence of any HPV infection was higher among HIV positive-women than HIV- negative women (27.7% vs.10.5%) (P <0.001, OR 3.26, CI 1.81-5.87), and so was the prevalence of ‘high-risk’-HPV (HR-HPV) (17.5% vs. 4.3%) and the ratio of HR-HPV out of any HPV (63.2% vs. 41.2%). The prevalence of multiple HPV infections was also higher among HIV-positive women (8.7% vs. 1.2%, P <0.001). The most common HR-HPVs were HPV16 (29.4%) and HPV52 (11.8%) in the HIV-negative group, and HPV52 (22.8%), HPV16 (17.5%), HPV31 and HPV58 (7.0%) in the HIV- positive group. HPV52 was common as a co-infection in the HIV-positive group. Conclusions The results show that HPV16 and HPV18 may not be as common in Rwanda as in Western countries, and that other carcinogenic HPV strains are more prevalent. Hence, the present findings should be taken into consideration for future vaccination programs in Rwanda. Keywords: HPV, cervical cancer, HIV, Rwanda