Abstract
BackgroundGenital warts are important causes of morbidity and their prevalence and incidence can be used to evaluate the impact of HPV vaccination in a population.MethodsWe enrolled 1020 women in a prospective cohort study in Nigeria and followed them for a mean (SD) of 9 (4) months. Nurses conducted pelvic examinations and collected ectocervical samples for HPV testing. We used exact logistic regression models to identify risk factors for genital warts.ResultsThe mean age of study participants was 38 years, 56% (535/962) were HIV-negative and 44% (427/962) were HIV-positive. Prevalence of genital warts at enrolment was 1% (4/535) among HIV-negative women, and 5% (23/427) among HIV-positive women. Of 614 women (307 HIV negative and 307 HIV positive women) for whom we could compute genital wart incidence, it was 515 (95% CI:13–2872) per 100,000 person-years in HIV-negative and 1370 (95% CI:283–4033) per 100,000 person-years in HIV-positive women. HIV was associated with higher risk of prevalent genital warts (OR:7.14, 95% CI:2.41–28.7, p < 0.001) while higher number of sex partners in the past year was associated with increased risk of incident genital warts (OR:2.86, 95% CI:1.04–6.47. p = 0.04). HPV11 was the only HPV associated with prevalent genital warts in this population (OR:8.21, 95% CI:2.47–27.3, p = 0.001).ConclusionGenital warts are common in Nigeria and our results provide important parameters for monitoring the impact of future HPV vaccination programs in the country. HIV infection and number of sexual partners in past year were important risk factors for prevalent and incident genital warts respectively.
Highlights
Genital warts are common manifestations of genital Human Papillomavirus (HPV) infections [1]
We describe the prevalence, incidence, associated risk factors and cervical HPV types associated with genital warts in Nigerian women
Most participants (72%, 692/962) completed follow-up visits. Of these 692 women, we excluded 62 participants whose HPV results were missing at follow-up leaving 630 women for genital wart incidence analysis
Summary
Genital warts are common manifestations of genital Human Papillomavirus (HPV) infections [1]. Genital warts can present with four morphologic features – condylomata acuminata, smooth or flat papular lesions, or keratotic warts Apart from their appearance, they are often symptomless except in some cases of vulvar warts which may cause dyspareunia and discomfort; penile warts and pruritus; vaginal warts and vaginal discharge, Dareng et al BMC Infectious Diseases (2019) 19:27 bleeding, obstruction of the birth canal, and neonatal infection which may lead to juvenile onset recurrent papillomatosis; perianal and intra-anal warts that cause pain, bleeding on defecation and pruritus [10,11,12,13,14]. Genital warts can have profound effects on patients’ quality of life [15] They may regress spontaneously or remain quiescent for extended periods. Genital warts are important causes of morbidity and their prevalence and incidence can be used to evaluate the impact of HPV vaccination in a population
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