Risk Factors For HPV Infection Research Articles

Prevalence, persistence, clearance and risk factors for HPV infection in rural Uyghur women in China

BackgroundThe incidence of cervical cancer in Uyghur women ranks first among those in Han and other ethnic minority groups. We aimed to understand the natural history of HPV in Uyghur women.MethodsA longitudinal cohort study on the natural history of HPV infection in rural Uyghur women in China was conducted between May 2013 and May 2014. A total of 11000 women from South Xinjiang underwent HPV screening by careHPV and liquid-based cytology. Ultimately, a total of 298 women with positive HPV and normal biopsy results or CIN1 were enrolled to participate in a study including follow-up HPV testing for two years.ResultsThe HPV infection rate in Uyghur women was 9.15%. Among the participants, the careHPV test showed that 298 women were HPV-positive, and histology showed CIN1 or normal results for these women at baseline. Among these patients, after 24 months of initial recruitment, 92 (30.87%) patients had persistent HPV infections, and 206 (69.13%) had cleared HPV infection. Univariate analysis showed that persistent HPV infection was associated with age and shower frequency (P < 0.001 and P = 0.047, respectively).ConclusionsOur results suggest that women over the age of 50 years who have been infected with HR-HPV for more than 1 year should be regularly screened and monitored for HPV. In addition, education should be strengthened to improve poor health habits in these women.

Correlation between vaginal flora and cervical immune function of human papilloma virus-infected patients with cervical cancer.

To analyse the correlation between vaginal flora and cervical immune function of HPV-infected patients with cervical cancer. Six hundred females with genital tract infections treated in Xuzhou Hospital of Traditional Chinese Medicine from January 2014 to December 2016 were selected and divided into a high-risk HPV group (n=246) and a control group (n=354). The vaginal flora and human T lymphocyte subsets (CD3+, CD4+, CD8+) were detected. Multivariate logistic regression analysis was performed to explore the risk factors for HPV infection. The numbers of CD4+ and CD4+/CD8+ T cells of the high-risk HPV group were significantly lower than those of the control group (P<0.05). The two groups had similar numbers of CD3+ and CD8+ T cells. In the high-risk HPV group, the positive rates of Lactobacillus, Chlamydia trachomatis, Mycoplasma hominis, mycetes, Ureaplasma urealyticum and bacterial vaginosis were significantly higher than those of the control group (P<0.05). There was no significant difference in the positive rates of trichomonads between the two groups. Multivariate logistic regression analysis revealed that C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection (P<0.05). High-risk HPV infection in patients with cervical cancer was associated with vaginal flora and immune function. C. trachomatis and U. urealyticum were independent risk factors for high-risk HPV infection.

Oral, genital and anal human papillomavirus infections among female sex workers in Ibadan, Nigeria

BackgroundThere are limited data on the epidemiology of HPV in different anatomical sites of female sex workers (FSW). We investigated the prevalence and concordance of cervical, vulval, oral and anal HPV among FSW in Ibadan, Nigeria.MethodsFSWs aged 18–45 years were enrolled in a cross-sectional survey. After interview and clinical examination, samples were collected from mouth, cervix, vulva and anus. HPV genotyping was done with Anyplex II 28HPV assay. Multivariable analyses were performed to explore associated risk factors and concordance of HPV infections across sites.ResultsIn total, 315 FSWs participated in the study with a mean age of 30–6.5 years. The prevalence of any HPV infection was 88% in the vulva, 84% in the cervix, 75% in the anus and 24% in the oral cavity. HPV 35 was the most prevalent and concordant high-risk type in the four sites. The risk factors for HPV infection by anatomic site varied.ConclusionThis large study showed a high prevalence and concordance of HPV infections of cervical, vulval, oral and anal HPV among FSWs in Nigeria. The potential to acquire and transmit HPV is high in this population, and we highlighted the urgency to protect young women through HPV vaccination.

Evaluation of Awareness of Human Papillomavirus and Cervical Cancer among Female Undergraduates of a Private Mission University in Southwestern Nigeria

Background: Human papillomavirus infection is most prevalent in the younger population and causes cervical cancer, which is the leading cause of cancer death worldwide. In 2018, cervical cancer was estimated to be 570,000 cases and 311,000 deaths; it ranked as the fourth most commonly diagnosed cancer and the fourth leading cause of cancer death in women. Cervical cancer can be prevented through health education and vaccination against HPV. This study aimed at evaluating the level of awareness of human papillomavirus and cervical cancer among female undergraduate students of Babcock University, Ogun state of Nigeria. Methodology: This was a cross-sectional, questionnaire-based study conducted among 310 female undergraduates of Babcock University in Nigeria from January to April 2019. The selection technique was a multistage random sampling method. The data collection was done using structured and self-administered questionnaires. Data collected were analyzed using IBM Statistical Package for Social Sciences (SPSS) statistics for windows version 25 and were presented in summary charts and frequency tables. P-values less than or equal to 0.05 were considered statistically significant. Results: Of 310 female students, 296 (95.5%) were aware of HPV infections. The majority, 215 (69.4%) of the students knew that HPV is sexually transmitted. There was poor knowledge of the risk factors of HPV infection. Only, 65 (21.0%) were aware that HPV infection causes cervical cancer. A few proportions of students 79 (25.4%) were aware of the HPV vaccine. Consequently, only 44 (14.2%) have received HPV vaccination and some complained about the cost as a significant reason for not being vaccinated against HPV infection. Conclusion: The level of awareness of HPV infection,

Prevalence of vaccine and non-vaccine human papillomavirus types among women in Accra and Kumasi, Ghana: a cross-sectional study

BackgroundHuman Papillomavirus (HPV) infection is the main etiological factor for pre-invasive and invasive cervical cancer. HPV type-specific vaccination is being widely recommended to control the burden of disease, but the genotype-specific distribution of HPV may vary in different countries. The aim of the study was to determine the prevalence and distribution of HPV genotypes among women attending reproductive health services in Ghana, their associated risk factors, and to assess the potential coverage of identified HPV genotypes by three licensed vaccines among these women.MethodWomen presenting for reproductive health services in two regional hospitals in Accra and Kumasi from October 2014 to March 2015 were conveniently recruited into the study (n = 317). HPV-DNA detection and genotype identification were carried out by a nested multiplex PCR assay that combines degenerate E6/E7 consensus primers and type-specific primers for the detection and typing of eighteen HPV genotypes. Cytology was performed to screen women for cervical cancer lesions. Risk factors for HPV infection were analyzed by logistic regression. Statistical significance was accepted for p < 0.05.ResultsThe age of study participants ranged from 21 to 76 years. Among women positive for HPV, 35.0% were infected with high-risk HPV, 14.5% with probable high-risk HPV, and 17.0% with low-risk HPV. The prevalence of HPV 16/18 was 8.2%, HPV 6/11/16/18 was 9.1% and HPV 6/11/16/18/31/33/45/52/58 was 28.4%. The most prevalent among HR-HPV were types 52 (18.3%) and 58 (8.8%). HPV positivity may be associated with educational background (p < 0.001), age at first pregnancy (p = 0.028), and age at coitarche (p = 0.016).ConclusionsOur study revealed a high prevalence of HR-HPV infection among women. The high prevalence of HR HPV indicates that multivalent vaccines will be useful for controlling HPV burden in general population contexts. The distribution of HPVs in this population suggests that of the three currently available vaccines the nonavalent vaccine, which protects against seven HPV types in addition to HPV 16 and 18, has the highest coverage of HPV infections among Ghanaian women. Healthcare officials planning to reduce the transmission of HPV and cervical cancer must consider the coverage of the nonavalent vaccine as an advantage.

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

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.

The characteristics and risk factors of human papillomavirus infection: an outpatient population-based study in Changsha, Hunan

This cross-sectional study investigated the characteristics of cervical HPV infection in Changsha area and explored the influence of Candida vaginitis on this infection. From 11 August 2017 to 11 September 2018, 12,628 outpatient participants ranged from 19 to 84 years old were enrolled and analyzed. HPV DNA was amplified and tested by HPV GenoArray Test Kit. The vaginal ecology was detected by microscopic and biochemistry examinations. The diagnosis of Candida vaginitis was based on microscopic examination (spores, and/or hypha) and biochemical testing (galactosidase) for vaginal discharge by experts. Statistical analyses were performed using SAS 9.4. Continuous and categorical variables were analyzed by t-tests and by Chi-square tests, respectively. HPV infection risk factors were analyzed using multivariate logistic regression. Of the total number of participants, 1753 were infected with HPV (13.88%). Females aged ≥ 40 to < 50 years constituted the largest population of HPV-infected females (31.26%). The top 5 HPV subtypes affecting this population of 1753 infected females were the following: HPV-52 (28.01%), HPV-58 (14.83%), CP8304 (11.47%), HPV-53 (10.84%), and HPV-39 (9.64%). Age (OR 1.01; 95% CI 1–1.01; P < 0.05) and alcohol consumption (OR 1.30; 95% CI 1.09–1.56; P < 0.01) were found to be risk factors for HPV infection. However, the presence of Candida in the vaginal flora was found to be a protective factor against HPV infection (OR 0.62; 95% CI 0.48–0.8; P < 0.001). Comparing with our previous study of 2016, we conclude that the subtype distribution of HPV infection is relatively constant in Changsha. Our data suggest a negative correlation between vaginal Candida and HPV, however, more radical HPV management is required in this area for perimenopausal women and those who regularly consume alcohol.

Risk factors for HPV infection and high-grade cervical disease in sexually active Japanese women

In Japan, recommendations for HPV vaccines were suspended in 2013 due to unfounded safety fears. Although vaccine opponents claim modifying sexual behavior can prevent cervical cancer, no comprehensive data exist on sexual behavior and the risk of high-grade cervical disease in a Japanese population. This study investigates sexual behavior and the risk of HPV infection and cervical disease in 3968 women aged 20–41 yrs undergoing cervical screening between April 2014 and March 2016. Mean age at first intercourse was 18.4 yrs ± 2.8 and 32% of women reported ≥ 6 lifetime sexual partners. In regression analyses, number of partners was a significant risk factor for HPV infection. However, for high-grade disease (CIN2+), when HPV genotype was adjusted for, number of partners was not statistically significant. The greatest risk factor was an HPV16/18 infection (adjusted odds ratio 113.7, 95% CI: 40.8–316.9). In conclusion, we found that having an HPV16/18 infection and not sexual behavior was the most significant risk factor for high grade cervical disease in young Japanese women. These infections can be prevented by a highly effective vaccine and we recommend that the Japanese government resume proactive recommendations for the HPV vaccine immediately.

RISK OF ANAL CANCER IN INFLAMMATORY BOWEL DISEASE PATIENTS IN THE US: A POPULATION-BASED STUDY 2008–2018

Abstract Background Patients with inflammatory bowel disease (IBD) are at elevated risk of developing anal cancer. However, it remains unclear whether the increased risk manifests from immunosuppressant use or location of the disease (inflammation). We aimed to examine whether the risk of anal cancer in IBD patients is attributable to immunosuppression or the disease’s location by comparing IBD patients with rheumatoid arthritis (RA) and diverticulitis patients, respectively. Methods We conducted a retrospective cohort study using the US Optum® commercial claims database (2008–2018). We estimated the risk of anal cancer in the IBD cohort compared to the RA cohort (to examine risk attributable to immunosuppressant use) and the diverticulitis cohort (to examine risk attributable to similar disease location). Disease cohorts and index dates were identified using a combination of ICD diagnosis codes and prescription drug use. Patients 18 years and older and with a minimum of 12 months of continuous insurance enrollment were included. All three cohorts were mutually exclusive; we excluded persons with HIV/AIDS or organ transplant. We estimated hazard ratios (HRs) using Cox proportional regression, adjusting for age at diagnosis, comorbidity, risk factors for HPV infection (smoking, obesity, genital wart, substance abuse, alcoholism), and prescription drug use. Analyses were stratified by sex. Results The study included 70,314 patients with IBD, 164,991 with RA, and 129,558 with diverticulitis. In men, the adjusted hazard ratio (aHR) of developing anal cancer was 6.78 (95% CI, 3.40–13.55) comparing IBD to RA, and was 2.68 (95% CI, 0.99–7.30) comparing IBD to diverticulitis. Among women, the risk of developing anal cancer was significantly higher in IBD compared to RA (aHR 2.70; 95% CI, 1.36–5.35), but not different compared to diverticulitis (aHR 0.70; 95% CI, 0.20–2.44). The factors associated with a higher risk of anal cancer in both men and women were age at diagnosis, history of genital wart, corticosteroid use, and immunosuppressant use. Conclusion We found a significantly elevated risk of anal cancer in IBD patients than RA patients. However, anal cancer risk was not significantly different when comparing IBD patients to diverticulitis patients. These results indicate that the location of the disease is more strongly associated with anal cancer incidence than the treatment of autoimmune disease.

Genotype Distribution and Prevalence of High-Risk Human Papillomavirus Based on 20,103 Self-Collected Samples From 13 Regions of China

Objective: To investigate the epidemiological characteristics of high-risk human papillomavirus (HR-HPV) infection and the genotype distribution of HR-HPV in different regions of China using self-collected vaginal samples. Study Design and Setting: A total of 20,136 women aged 30–59 years were recruited from 13 provinces in China from September 2018 to July 2020. All participants registered, signed electronic informed consent, and filled in individual information voluntarily using an internet-based cervical cancer screening platform, then received a self-sampling kit. The samples were tested for 14 types of HR-HPV using the SeqHPV and BMRT HPV PCR assays. Results: After excluding 33 samples because of labeling errors or insufficient amounts of HPV DNA in specimens, 20,103 women (99.84%) were ultimately analyzed with a mean age of 44.31 ± 7.70 years. The overall prevalence of HR-HPV infection was 13.86%. The vast majority of HR-HPV (77.18%) were still a single type. Among 13 regions, Inner Mongolia had the highest prevalence (21.55%), while the lowest prevalence was in Jilin (9.51%). The following factors were found to be significantly associated with HR-HPV infection: age, sexual behavior, irregular screening, and economic level. The top five most common HR-HPV subtypes were HPV-52 (3.42%), HPV-58 (2.29%), HPV-16 (2.17%), HPV-39 (1.35%), and HPV-51 (1.30%), while HPV18 (0.86%) was the less prevalent. The prevalence of infection with a single type of HR-HPV was 10.70% and the prevalence of infection with multiple types was 3.16%. The prevalence curve of age-specific HR-HPV was V-shaped from 30 years to 59 years, with a lower prevalence observed in women aged 40–44 years (12.35%) and infection subsequently increasing with age. The proportion of women aged 30–34 years with HPV-16 (17%) was much higher than the proportion in other age groups, and the prevalence of HPV-18 (6%) was highest in women aged 45–49 years. The undeveloped regions (according to the GDP) had the highest prevalence of specific combinations of HR-HPV subtypes, of which HPV-16/HPV-18 infections decreased with increasing GDP. Furthermore, a more number of sexual partners and age of first sexual intercourse <20 years were risk factors for HPV infection, whereas education and barrier contraception were protective factors. Conclusion: The prevalence, genotype distribution, epidemiological characteristics and influencing factors of HR-HPV infection based on self-sampling varied in different regions of China. It is therefore crucial to develop specific plans for cervical cancer screening in different regions. Using the Internet for self-sample screening way could a much greater increase the coverage of cervical cancer screening. Clinical Trial Registration Details: Chinese Clinical Trial Website (https://www.chictr.org.cn, ChiCTR2000032331). Funding Information: The study was supported by Association for Maternal and Child Health Studies (No. 2018AMCHS00801); the National Key Research and Development Program of China (No. 2016 YFC1302901). Declaration of Interests: None. Ethics Approval Statement: The study was approved by the Ethics Committee of the Peking University People’s Hospital (2018PHB056-01) in Beijing, China.

Prevalence and correlation of human papillomavirus genotypes with clinical factors in cervical samples from Mexican women.

We are submitting data regarding the prevalence and type distribution of the HPV infection and the risk factors associated with it, which may provide a valuable reference to reinforce screening strategies, and to maintain HPV genotype surveillance in Mexico. We discuss the overall prevalence of HPV infection as detected in normal cytological samples stratified by age, different types of infection, and oncogenic capacity. One of the most important findings was that common HPV genotypes detected in healthy women were the genotype numbers: 6, 31, 16, and 56, likewise, smoking and having a history of more than three sexual partners over their lifetime, represented the main risk factors in this study. Furthermore, we found a low frequency of cytological abnormalities and CIN 1-3 in women with HR-HPV.

Knowledge and Awareness Regarding HPV Infection and Pap Smear Screening in Reproductive Aged Females in Delhi NCR Rural Region

The purpose of the study was to document the knowledge and awareness of HPV infection and Pap smear among the study women and to conduct screening with Pap smear cytology and HPV testing. The study also aimed to further perform a correlation analysis of HPV prevalence with demographic data. The present study collected demographic, epidemiologic and clinical information of women of aged group 20–60 years with gynaecological abnormalities who attended the gynaecology and cancer OPD at a tertiary care health centre. Majority of the study participants were young married ladies and did not have any formal education (85.5%). Mean (SD) age at the time of first pregnancy among the study subjects was 16.8 (2.7) years. Majority of the study participants were below poverty line (88.2%). A total of 68.6% of the study subjects had an HPV infection. Among those that had an HPV infection, majority had HPV 16 infection (95.4%). In the remaining 4.6%, HPV 18 was present. Findings show that with increasing age, HPV prevalence increases. Also, early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line were significant risk factors for HPV infection in this cohort. The study reported a high prevalence of HPV infection in rural women attending the gynaecology and cancer OPD of a tertiary care hospital. Several important risk factors for the HPV infection were also identified. These were early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line. These findings call for more efforts to increase awareness pertaining to HPV infection and cervical cancer among rural women.

Knowledge and awareness regarding HPV infection and PAP smear screening in reproductive aged females of rural India

PurposeThe purpose of the study was to document the knowledge and awareness of HPV infection and Pap smear among the study women and to conduct screening with Pap smear cytology and HPV testing. The study also aimed to further perform a correlation analyses of HPV prevalence with demographic data. MethodsThe present study collected demographic, epidemiologic and clinical information of women of aged group 20–60 years with gynaecological abnormalities who attended the gynaecology and cancer OPD at a tertiary care health center. ResultsMajority of the study participants were young married ladies and did not have any formal education (85.5%). Mean (SD) age at the time of first pregnancy among the study subjects was 16.8 (2.7) years. Majority of the study participants were below poverty line (88.2%). A total of 68.6% of the study subjects had an HPV infection. Among those that had an HPV infection, majority had HPV 16 infection (95.4%). In the remaining 4.6%, HPV 18 was present. Findings show that with increasing age, HPV prevalence increases. Also, early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line were significant risk factors for HPV infection in this cohort. ConclusionThe study reported a high prevalence of HPV infection in rural women attending the Gynaecology and Cancer OPD of a tertiary care hospital. Several important risk factors for the HPV infection were also identified. These were early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line. These findings call for more efforts to increase awareness pertaining to HPV infection and cervical cancer among rural women.

Prevalence of HPV infection in reproductive aged female in Delhi NCR region

PurposeThe purpose of the study was to conduct screening with Pap smear cytology and HPV testing among study women. The study also aimed to further perform a correlation analyses of HPV prevalence with demographic data. MethodsThe present study collected demographic, epidemiologic and clinical information of women of aged group 20–60 years with gynaecological abnormalities who attended the gynaecology and cancer OPD at a tertiary care health center. ResultsMajority of the study participants were young married women and did not have any formal education (85.5%). Mean (SD) age at the time of first pregnancy among the study subjects was 16.8 (2.7) years. Majority of the study participants were below poverty line (88.2%). A total of 68.6% of the study subjects had an HPV infection. Among those that had an HPV infection, majority had HPV 16 infection (95.4%). In the remaining 4.6%, HPV 18 was present. Findings show that with increasing age, HPV prevalence increases. Also, early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line were significant risk factors for HPV infection in this cohort. ConclusionThe study reported a high prevalence of HPV infection in rural women attending the Gynaecology and Cancer OPD of a tertiary care hospital. Several important risk factors for the HPV infection were also identified. These were early age at marriage, lack of education, increased parity, early age at first pregnancy, poor sanitation, use of tobacco and belonging to below poverty line. These findings call for more efforts to increase awareness pertaining to HPV infection and cervical cancer among rural women.

Prevalence and genotype-specific distribution of human papillomavirus in Burundi according to HIV status and urban or rural residence and its implications for control.

BackgroundHuman papillomaviruses are the most important causative agents for invasive cervical cancer development. HPV type-specific vaccination and HPV cervical cancer screening methods are being widely recommended to control the disease but the epidemiology of the circulating HPV types may vary locally. The circulating HPV-strains have never been assessed in Burundi. This study determined the prevalence and genotype-specific distribution of HPV in four different strata in Burundi: HIV-infected or non-infected and women living in rural or urban areas. Implications for HPV diagnosis and vaccine implementation was discussed.MethodsFour cross-sectional surveys were conducted in Burundi (2013 in a rural area and 2016 in urban area) among HIV-infected and uninfected women living in rural and urban areas. Liquid-Based Cytology (LBC) and HPV genotyping were performed and risk factors for HPV infection and cervical pre-cancer lesions were determined using logistic regression model.ResultsHPV prevalence was very high in urban area with significant differences between HIV-positive and negative women (p<0.0001). In fact, 45.7% of HIV-positive participants were infected with any HPV type and all were infected with at least one HR/pHR-HPV type. Among the HIV-negative participants, 13.4% were HPV-infected, of whom, only four women (2.7%) were infected with HR/pHR-HPV types. In rural area, HPV infection did not significantly differ between HIV-positive and negative women (30.0% and 31.3% respectively; p = 0.80). In urban area, multiple infections with HR/pHR-HPV types were detected in 13.9% and 2.7% among HIV-positive and negative women respectively (p<0.0001), whereas in rural area, multiple infections with HR/pHR-HPV types were detected in 4.7% and 3.3% of HIV-positive and negative women respectively (p = 0.56). The most prevalent HR/pHR-HPV types in HIV-positive women living in urban area were HPV 52, 51, 56, 18 and 16 types. In HIV-negative women living in urban area, the most prevalent HR/pHR-HPV types were HPV 66, 67, 18, 45 and 39 types. In HIV-positive women living in rural area, the most prevalent HR/pHR-HPV types were HPV 66, 16, 18 and 33 types. In HIV-negative women living in rural area, the most prevalent HR/pHR-HPV types were HPV 16, 66, 18, 35 and 45 types. Independent risk factors associated with cervical lesions were HPV and HIV infections.ConclusionsThere is a high burden of HR and pHR-HPV infections, in particular among HIV-infected women living in urban area. The study points out the need to introduce a comprehensive cervical cancer control programme adapted to the context. This study shows that the nonavalent vaccine covers most of the HR/pHR-HPV infections in rural and urban areas among HIV-infected and uninfected women.

Serum Se, Ni, and As are associated with HPV infection and CIN2+ among Uyghur women in rural China

BackgroundCervical cancer incidence and mortality is high in Uyghur ethnics. Their life style and dietary habit were different from other ethnics living together. Study on the role of trace elements in HPV infection and cervical lesion of Uyghur minority is needed for future intervention and prevention work.MethodsIn total, 833 Uyghur women were randomly selected from the screening site and hospital. The concentrations of the trace elements As, Fe, Cd, Ni, Cu, Zn, Mn, and Se were determined by atomic absorption spectrophotometry and inductively coupled plasma atomic emission spectroscopy. Univariate analysis was performed with chi-squared test between the HPV-positive and HPV-negative groups and between the case group and the control group. Multivariate analysis was performed with logistic regression.ResultsAn As concentration ≥ 0.02 mg/kg was a risk factor for HPV infection (OR > 1, P < 0.05), and Ni concentration ≥ 0.1232 mg/kg and Se concentration ≥ 0.02 mg/kg were protective factors (OR < 1, P < 0.05). Concentrations of Fe ≥ 6.9153 mmol/L and As ≥0.02 mg/kg were risk factors for CIN2+ (OR > 1, P < 0.05), and concentrations of Ni ≥0.0965 mg/kg and Se ≥0.02 mg/kg were protective factors (OR < 1, P < 0.05).ConclusionsLow serum concentrations of Se and Ni and a high serum concentration of As might be related to HPV infection and CIN2+ in Uyghur women in rural China.

Assessing Knowledge of Cervical Cancer among Health Care Students in Mwanza, Tanzania [9O

INTRODUCTION: In many Sub-Saharan African countries, cervical cancer remains the most prevalent cancer among women. The purpose of this study is to empirically characterize levels of knowledge in healthcare students in Mwanza, Tanzania with regards to transmission and risk factors for HPV infection, as well as treatment options and prevention of cervical cancer. METHODS: To assess educational needs and awareness, 185 health professions students were surveyed to measure knowledge of cervical cancer. RESULTS: 3 out of 181 students identified all of the correct causes of cervical cancer and none of the incorrect causes. 11 students out of 181 identified all of the correct HPV prevention methods and none of the incorrect methods. None of the students were able to identify all correct responses without selecting any incorrect responses for cervical cancer risk factors, HPV transmission, or cervical cancer treatment options. Almost two-thirds of participants in this study reported being dissatisfied with their current level of cervical cancer knowledge, and the most common source of information indicated by students was the media, not school. CONCLUSION: Many policy changes are needed to curtail the high incidence and prevalence of cervical cancer in Tanzania. Low levels of demonstrated knowledge call for the implementation of additional HPV, cervical cancer prevention, and cervical cancer treatment educational lessons. These lessons may improve the knowledge base of the future healthcare workforce, who may in turn be more equipped to address the high rates of cervical cancer in Tanzania.

Population risk factors for late-stage presentation of cervical cancer in sub-Saharan Africa

BackgroundCervical cancer is the most prevalent malignancy in sub-Saharan Africa (SSA) with many women only seeking professional help when they are experiencing symptoms, implying late-stage malignancy and higher mortality rates. This ecological study assesses population-level exposures of SSA women to the numerous risk factors for HPV infection and cervical cancer, against late-stage presentation of cervical cancer. Materials and methodA literature review revealed the relevant risk factors in SSA. Open-access databases were mined for variables closely representing each risk factor. A proxy for late-stage presentation was used (ratio of incidence-to-mortality, IMR), and gathered from IARC’s GLOBOCAN 2012 database. Variables showing significant correlation to the IMR were used in stepwise multiple regression to quantify their effect on the IMR. ResultsCountries with high cervical cancer mortality rates relative to their incidence have an IMR nearer one, suggesting a larger proportion of late-stage presentation. Western Africa had the lowest median IMR (1.463), followed by Eastern Africa (IMR = 1.595) and Central Africa (IMR = 1.675), whereas Southern Africa had the highest median IMR (1.761). Variables selected for the final model explain 65.2% of changes seen in the IMR. Significant predictors of IMR were GDP (coefficient = 2.189 × 10−6, p = 0.064), HIV infection (−1.936 × 10−3, p = 0.095), not using a condom (−1.347 × 10−3, p = 0.013), high parity (−1.744 × 10−2, p = 0.008), and no formal education (−1.311 × 10−3, p < 0.001). ConclusionUsing an IMR enables identification of factors predicting late-stage cervical cancer in SSA including: GDP, HIV infection, not using a condom, high parity and no formal education.

Risk Factors for Oral Infection with Human Papillomavirus.

Human papillomavirus has been identified as a causative factor for a subset of head and neck carcinomas (HNSCC). The majority of the HPV-positive tumors arises in the oropharyngeal region, and at present, the infection of the human papilloma type 16 is the major cause of the oropharyngeal cancer development. Patients with HPV DNA-positive tumors have been shown to be younger in age and are less likely to have a history of tobacco smoking or alcohol use. The tumors referred to the HPV positivity have been proven to more likely confer better prognosis. Seven percent of the population between ages of 14 and 69 are infected by HPV at any given time within the oral mucosa. However, only about 1% of those infections is associated with the high-risk cancerogenous types of the virus. Up to date few risk factors of HPV infection have been identified including age, gender and the sexual behavior. Tobacco smoking and immunosuppression have also been reported to play a role in HPV infection.

Risk, Persistence and Multiplicity of HPV Infections among HIV Negative and HIV Positive Nigerian Women

Abstract 64 Background: The incidence, prevalence, persistence, and multiplicity of high-risk HPV infection is different between HIV positive and HIV negative women. We examined the association between HIV, prevalent HPV, and persistent HPV infections among women in a prospective cohort in Nigeria. Methods: We enrolled women presenting at cervical cancer screening programs in Abuja, Nigeria, between 2012 and 2014 and collected information on their demographic characteristics, risk factors of HPV infection, and cervical exfoliated cells samples at baseline, 6 month and 12 month follow-up visits. DNA enzyme immunoassay (DEIA) and Roche Linear Array HPV Genotyping Test were used to characterize HPV. Persistent HPV infection was defined as a positive result on 2 consecutive DEIA tests. We used logistic regression models to estimate the association between HIV and risk of HPV infection. Results: Among the 1,020 women enrolled, the mean age (±SD) was 37(8), and 44% and 56% were HIV+ and HIV-, respectively. HPV52 and 35 were the most common HPV types in the study population. The prevalence was 34% for any HPV, 24% for persistent HPV and 9% for multiple HPV infections; these were higher among HIV+ women (p-value &lt;0.001). The multivariate odds ratio (OR) and 95 % CI comparing HIV+ to HIV- women was 6.29 (95% CI 3.64 – 10.87, p-value &lt;0.001) for any high-risk HPV; 6.22 (95% CI 3.02 – 12.83, p-value &lt;0.001) for persistent high-risk HPV; and 6.46 (95% CI 2.69 – 15.52, p-value &lt;0.001) for multiple high-risk HPV infections, Conclusions: HIV infection is associated with increased risk of persistence and multiplicity of low-risk and high-risk HPV infections. These findings may explain, in part, the increased risk of cervical cancer among women with HIV infections. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Sally N. Adebamowo No relationship to disclose Toyosi Olawande No relationship to disclose Ayotunde Famooto No relationship to disclose Eileen O. Dareng No relationship to disclose Olayinka Olaniyan No relationship to disclose Richard Offiong No relationship to disclose Clement A. Adebamowo Speakers' Bureau: Merck [Table: see text]