Human papillomavirus (HPV) infection, HIV infection and cervical cancer in Tanzania, east Africa
Ter Meulen, J.; Eberhardt, H.C.; Luande, J.; Mgaya, H.N.; Chang-Claude, J.; Mtiro, H.; Mhina, M.; Kashaija, P.; Ockert, S.; Yu, X.
International Journal of Cancer 51(4): 515-521
1992
ISSN/ISBN: 0020-7136 PMID: 1318265 DOI: 10.1002/ijc.2910510403Document Number: 323559
Southern blot hybridization and/or PCR was used to examine tumor biopsies of 53 women with cervical or vaginal cancer at Ocean Road Hospital in Dar es Salaam, Tanzania, and the cervical swabs of 359 women with no cancer at the gynecologic clinic at Muhimbili University College of Health Sciences in Dar es Salaam. Tanzanian and German scientists wanted to determine whether an association existed between human papillomavirus (HPV) infections and HIV, and whether the high prevalence of HIV infection was matched by a high prevalence of HPV infections, cervical dysplasias, and cervical cancer in HIV-positive cases. 59% of the noncancerous women had HPV-DNA. Young age and HIV infection were the greatest risk factors for HPV-DNA in these women (p .0001 for age and HPV-16/18; p = .08 for other HPVs; and p = .03 for HIV). 13.2% and 17.5% of all HPV infections were HPV types 16 and 18, respectively. Tanzania had the highest prevalence of HPV 18 ever reported. HPV-16/18 risk factors included: Trichomonas vaginalis infection (odds ratio [OR] = 2.23; p = .04), single status (OR = 2.55; p = .01), 16 years old or less at first intercourse (OR = 2.1; p = .03), and young age at menarche (OR = 6 for or=12 years old; p = .02 and OR = 3.25 for or=13 years old and or=16 years old; p = .05). Yet, the multivariate analysis revealed young age at menarche had the greatest effect (OR = 6.2 for or= 12 years old, p = .03; OR = 3.73 for or=16 years old, p = .08). 12.8% of noncancerous women tested positive for HIV-1, but none of them were obviously symptomatic. These HIV-positive women had a higher OR if they had HPV-16/18 than if they had other HPV types (4.25 vs. 2.02). Further, they did not have more cervical cytological abnormalities than did the HIV-negative women (overall cervical cytological abnormality rate - 2.8%). The HIV-positive rate for cancerous patients was only 3%. In conclusion, no association existed between HIV infection and cervical cytological abnormalities or cervical cancer.
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