Prevalence and genotype specific concordance of oro-genital and anal human papillomavirus infections among sexually active Nigerian women

Imran O Morhason-Bello,Miquel Angel Pavon,Suzanna C Francis,Deborah Watson-Jones,Rasheed Bakare,Kathy Baisley,Isaac F Adewole,Silvia De Sanjosé

doi:10.1186/s13027-021-00398-9

Abstract

BackgroundHuman papillomavirus (HPV) associated cancers are increasingly reported globally, including in sub-Saharan Africa (SSA). However, with the exception of cervical HPV infection, data from SSA on the epidemiology of oral and genital HPV infections are limited. This study assessed the prevalence and concordance of oro-genital and anal HPV genotype specific infections among women in the general population.MethodsWe conducted a cross-sectional study in sexually active women aged 18–45 years in Ibadan, Nigeria. After a face-to-face interview and clinical examination, oral, cervical, vulvar, and anal samples were collected from participants and tested by the Anyplex II 28 HPV assay. Descriptive and multivariable analyses were used to report prevalence and risk factors associated with HPV infections.ResultsThe prevalence of any vulva, cervical, anal, and oral HPV infections was 68.0% (210/309), 59.7% (182/305), 56.8% (172/303), and 16.1% (14/286), respectively. There was an inverse relationship between age-group and HPV prevalence of HPV in all anatomic sites except for the oral HPV infections. HPV 35 was the most prevalent high-risk HPV genotype in the vulva, cervix and oral cavity. Associated risk factors for HPV infection in each of the anatomic sites were reported. Overall, 10.0% (31/310) women had concordance of any HPV type in the four anatomic sites.ConclusionThere was a high prevalence of oro-genital and anal HPV infections among sexually active Nigerian women, with concordance of HPV types in the cervix, vulva, anus and oral cavity. We advocate large longitudinal studies that will involve sampling of multiple anatomic sites and inclusion of other women in the community for better understanding of HPV epidemiology in this region.

Highlights

Human papillomavirus (HPV) associated cancers are increasingly reported globally, including in subSaharan Africa (SSA)
Worldwide, human papillomavirus (HPV)-associated cancers are estimated to account for 4.5% of all cancers, with the highest burden occurring in the low-middle income countries (LMIC) [1, 2]
Concordance of any LR-HPV genotype between two anatomical sites samples followed similar pattern with the highest in cervical and vulvar samples (123/305; 40.3%). This is the first report on the prevalence of concurrent HPV infections in cervix, vulva and oral and anal cavities among sexually active women living in peri-urban and urban settings in West Africa

Summary

Introduction

Human papillomavirus (HPV) associated cancers are increasingly reported globally, including in subSaharan Africa (SSA). HPV persistent infection is associated with anogenital warts and with over 95.0% of cervical cancer, 88.0% of anal. A similar epidemiology of HPV infections has been reported in HPV associated cancers of vulvar, vagina and anal cavity [4, 5]. The three HPV vaccines (Cervarix®, Gardasil® and Gardasil®9) are effective primary preventive strategy for HPV infection and associated benign and malignant morbidity [2, 7]. Access to these vaccines are limited in LIMC, in Africa [2, 7]

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