Molecular epidemiology of human papillomavirus among HIV infected women in developing countries: systematic review and meta-analysis

Agajie Likie Bogale,Girmay Medhin,Nega Berhe Belay,Jemal Haidar Ali

doi:10.1186/s12985-020-01448-1

Agajie Likie Bogale, Girmay Medhin + Show 2 more

Open Access

https://doi.org/10.1186/s12985-020-01448-1

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Abstract

BackgroundAlthough, there is a variable burden of human papillomavirus (HPV) in women infected with HIV in developing countries, there are few studies that attempted to surmise such variable evidences. This review aimed to estimate the pooled prevalence of HPV genotype distribution and risk factors contributing to HPV infection among women infected with HIV in low- and middle-income countries.MethodsWe conducted a systematic review and meta-analysis of studies conducted in developing countries and reported HPV prevalence. We searched electronic databases: PubMed/Medline, SCOPUS, ScienceDirect, Excerpta Medical Database from Elsevier, Web of science, Cumulative Index of Nursing and allied Health Sciences and Google scholar databases to retrieve primary studies published in English language till 11th August 2019. We used random-effects model to estimate the pooled prevalence of HPV genotypes, and funnel plot to assess publication bias. The registration number of this review study protocol is CRD42019123549.ResultsWe included nineteen studies with a total of 8,175 participants in this review. The prevalence of HPV was extremely heterogeneous across the studies (χ2= 3782.80, p value < 0.001, I2 = 99.6%). The estimated pooled prevalence of all HPV genotypes was 63.0% (95% CI: 48.0–78.0) while the pooled prevalence of high risk and low risk HPV genotypes were 51.0% (95% CI: 38.0–63.0) and 28.0% (95% CI: 12.0–43.0), respectively. The pooled prevalence of HPV genotype 16 was 20%, while genotype 18 and 52 were 15% and 13%, respectively. Different risk factors reported for HPV infection and the frequently reported were low CD4 count below 200 cells/mm3 and high HIV viral load.ConclusionThe pooled prevalence of HPV among HIV infected women in low- and middle-income countries was considerable and the proportion of high risk HPV genotypes were high when compared with low risk genotypes. Therefore, it is essential for the HPV prevention program to prevent the double burden of HPV and HIV in women.

Highlights

There is a variable burden of human papillomavirus (HPV) in women infected with Human immunodeficiency virus (HIV) in developing countries, there are few studies that attempted to surmise such variable evidences
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Infection of the cervix with HPV is necessary to cause cervical neoplasia and cervical cancer [11, 12], and integration of viral Deoxyribonucleic acid (DNA) into the host genome is necessary for persistent infection which could lead to the development of cervical dysplasia [11]

Summary

Introduction

There is a variable burden of human papillomavirus (HPV) in women infected with HIV in developing countries, there are few studies that attempted to surmise such variable evidences. This review aimed to estimate the pooled prevalence of HPV genotype distribution and risk factors contributing to HPV infection among women infected with HIV in low- and middle-income countries. The papillomavirus is a heterogeneous group of DNA virus with circular, non-enveloped, double-stranded DNA genomes [1, 2]. This virus infects humans and different species of animals [2]. Infection of the cervix with HPV is necessary to cause cervical neoplasia and cervical cancer [11, 12], and integration of viral DNA into the host genome is necessary for persistent infection which could lead to the development of cervical dysplasia [11]

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