Abstract
IntroductionThe study aimed to examine and characterize human papilloma virus (HPV) cytological grade trends and genotypes among HPV/HIV co-infected/cases and HPV monoinfected/control women attending Kisii Teaching and Referral Hospital, Kenya.MethodsHIV positive co-infected with HPV (HPV/HIV) and HIV negative women monoinfected with HPV profiled as co-infected/cases and monoinfected/control arms respectively were enrolled. HPV subtypes were assayed by Xpert® HPV system (GXHPV-CE-10) alongside pathological cytology analysis of cervical tissue samples.ResultsLow grade intraepithelial lesion (LSIL) was the most predominant cytological grade across cases and controls with a prevalence of 32 (38.1%) while high grade squamous intraepithelial lesion (HSIL) was highest among HPV/HIV co-infected with a prevalence of 23 (27.38%). Among the monoinfected (controls) the predominant lesion was low grade intraepithelial lesions (LSIL) with a prevalence of 23 (27.38%). HPV type 16 had the highest prevalence 26 (30.8%) among the VIA positive women in the overall study participants followed by combinations of HPV types (16, 18/45) at 19 (22.6%).ConclusionHigh risk HPV types 16 and 18/45 were the most predominant in the established cytological grades and among the co-infected women. Routine screening using both cytological and HPV testing should be embraced and/or reinforced as early screening and preventive strategies in the covered geographical region population. Provision of the currently available vaccines to these women at an early age would provide effective protection since the HPV type profiles in this population are covered by such vaccines.
Highlights
Human Papillomavirus (HPV) is classified as high risk or low risk depending on its association with infection progression to cancer [1]
Cytological findings point to the fact that there is greater rate of persistence in high risk human papilloma virus (HPV) type infections in Human Immunodeficiency Virus (HIV) infected women leading to high-grade squamous intraepithelial lesions (HSIL) which culminate to invasive cervical carcinoma [4]
In the recruitment process one arm had 42 (34.71%) HIV positive women co-infected with HPV/ with a mean age of 40.36±11.318 years while the control arm had 42 (14.53%) HIV negative women who were monoinfected with HPV with a mean age of 35.21±9.495 years
Summary
Human Papillomavirus (HPV) is classified as high risk or low risk depending on its association with infection progression to cancer [1]. In Kenya, to the best of our knowledge there is no such data in Kisii region as part of the broader Nyanza geographical terrain Such gaps in the coinfections and genotype dynamism, translates to many setbacks in screening and prophylactic vaccination strategies among the vulnerable groups [4, 8, 9]. In view of the evidence gap, the study aimed to examine and characterize HPV cytological grade trends and genotypes among VIA positive HPV/HIV co-infected and HPV monoinfected women attending Kisii Teaching and Referral Hospital, Kenya in a quest to generate and enhance regionally adapted insights for better public health cues and planning information
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