Human papillomavirus infection in Rwanda at the moment of implementation of a national HPV vaccination programme

BMC Infectious Diseases

Research Article

Anne M. Uyterlinde¹  Peter J. F. Snijders¹  Iacopo Baussano²  Silvia Franceschi²  Vanessa Tenet²  Gary M. Clifford²  Fulvio Lazzarato³  M. Chantal Umulisa⁴  Maurice Gatera⁴  Agnes Binagwaho⁵  Fidele Ngabo⁶ 

[1] Department of Pathology, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands;International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France;International Agency for Research on Cancer, 150 cours Albert Thomas, 69372, Lyon Cedex 08, France;Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy;Ministry of Health of Rwanda, Kigali, Rwanda;Ministry of Health of Rwanda, Kigali, Rwanda;Harvard Medical School, Boston, MA, USA;Geisel School of Medicine, Dartmouth, Hanover, USA;Ministry of Health of Rwanda, Kigali, Rwanda;Université Libre de Bruxelles, Ecole de Santé Publique, Brussels, Belgium;

关键词: Human papillomavirus;    Human immunodeficiency virus;    Prevalence;    Cervical cancer;    Rwanda;   

DOI  :  10.1186/s12879-016-1539-6

 received in 2015-10-02, accepted in 2016-05-05,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundCervical cancer is the most common female cancer in Rwanda that, in 2011, became the first African country to implement a national vaccination programme against human papillomavirus (HPV).MethodsTo provide a robust baseline for future evaluations of vaccine effectiveness, cervical cell specimens were obtained from 2508 women aged 18–69 years from the general population in Kigali, Rwanda, during 2013/14. 20 % of women were HIV-positive. Samples were used for liquid-based cytology and HPV testing (44 types) with GP5+/6+ PCR.ResultsHPV prevalence was 34 %, being highest (54 %) in women ≤19 years and decreasing to 20 % at age ≥50. Prevalence of high risk (HR) HPV and cytological abnormalities was 22 and 11 % respectively (including 2 % with high-grade squamous intraepithelial lesions, HSIL) decreasing with age. Age-standardised prevalence of HR HPV was 22 % (or 19 % among HIV-negative women), and HPV16 was the most common type. Prevalence of HPV and cytological abnormalities were significantly higher in HIV-positive than HIV-negative women, and the difference increased with age. Other significant risk factors for HPV positivity in multivariate analyses were high lifetime number of sexual partners, receiving cash for sex, and being a farmer. 40 % of women with HSIL were infected with HPV16/18 and there was no significant difference between HIV-positive and HIV-negative women.ConclusionsThis study confirms Rwanda to be a setting of high prevalence of HPV and cervical disease that is worsened by HIV. These data will serve as a robust baseline for future evaluations of HPV vaccine programme effectiveness.

【 授权许可】

CC BY   
© Ngabo et al. 2016