Type-specific HPV incidence and clinical spectrum of lesions induced by high-risk oncogenic HPV types among study participants in Eastern Uganda

Abstract

Different studies show that high-risk HPV genotypes are the main etiological agents for cervical cancer development and cancer-related deaths in women worldwide. In Uganda, cervical malignancies due to human papillomavirus (HPV) are predominant among sexually active women. However, data on the incidence and clinical spectrum of lesions associated with high-risk HPV infection is inadequate. The current study was aimed to determine incidence and clinical spectrum of lesions induced by high-risk oncogenic HPV types among study participants in Eastern Uganda. We piloted a prospective follow-up study among 1,077 women aged 15-55 years to assess the incidence and clinical spectrum of lesions associated with human papillomavirus infections (HPV). HPV Real-Time PCR using HPV High-Risk Screen Real-TM Quant 2x kit (Sacace, Biotechnologies, Italy) was used for genotyping high-risk HPV types. Four hundred and sixteen (416) of 1,077 (38.6%) women were monitored for an average time of 18 months (inter-quartile range 9.6-26.6). Forty-three (43) women had incident HPV infections during 214 person-years of follow-up reflecting an incidence rate of 20.1 per 100 person-years. Incident HPV infections were marginally associated with HIV positivity (RR = 3.0, 95% CI: 0.8 - 8.2) and usage of oral contraceptives (RR=2.6, 95% CI: 1.4 - 2.8) but not with the age of study subjects, or number sexual partners. Clearance for high-risk HPV infections was frequently ranging between 37.5% and 100.0% for high-risk types. Only 41.3% of women cleared all their infections. Clearance was associated with HIV negativity (Adjusted clearance = 0.3, 95% CI: 0.2 - 0.8) but not with age at study entry or oral contraceptive usage. Incident HPV infections and clearance of HPV type-specific infections were common among study participants. We also found a high prevalence of high-risk HPV types in cervical lesions, which reveals an association between cervical lesions and high-risk HPV types.