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Human papillomavirus prevalence and cytopathology correlation in young Ugandan women using a low‐cost liquid‐based pap preparation
Author(s) -
Taube Janis M.,
Kamira Betty,
Motevalli Mahnaz,
Nakabiito Clemensia,
Lukande Robert,
Kelly Deidra P.,
Erozan Yener S.,
Gravitt Patti E.,
Buresh Megan E.,
Mmiro Francis,
Bagenda Danstan,
Guay Laura A.,
Jackson J. Brooks
Publication year - 2010
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.21249
Subject(s) - medicine , cytopathology , genotyping , coinfection , hpv infection , obstetrics , genotype , cervical cancer , gynecology , cervical intraepithelial neoplasia , dysplasia , ascus (bryozoa) , cytology , human immunodeficiency virus (hiv) , virology , cancer , pathology , biochemistry , chemistry , botany , ascospore , spore , biology , gene
Screening for HPV‐driven cervical dysplasia and neoplasia is a significant public health concern in the developing world. The purpose of this study was to use a manual, low‐cost liquid‐based Pap preparation to determine HPV prevalence in HIV‐positive and HIV‐negative young women in Kampala, Uganda and to correlate cervical cytopathology with HPV‐DNA genotype. About 196 post‐partum women aged 18–30 years underwent rapid HIV testing and pelvic examination. Liquid‐based cervical cytology samples were processed using a low‐cost manual technique. A DNA collection device was used to collect specimens for HPV genotyping. HIV and HPV prevalence was 18 and 64%, respectively. Overall, 49% of women were infected with a high‐risk HPV genotype. The most common high‐risk HPV genotypes were 16 (8.2%), 33 (7.7%), 35 (6.6%), 45 (5.1%), and 58 (5.1%). The prevalence of HPV 18 was 3.6%. HIV‐positive women had an HPV prevalence of 86% compared to 59% in HIV‐negative women ( P = 0.003). The prevalence of HPV 16/18 did not differ by HIV status. HIV‐positive women were infected with a significantly greater number of HPV genotypes compared to HIV‐negative women. By multivariate analysis, the main risk factor for HPV infection was coinfection with HIV. HIV‐positive women were four times more likely to have abnormal cytology than HIV‐negative women (43% vs. 11.6%, P < 0.001). These data highlight that HIV infection is a strong risk factor for HPV infection and resultant abnormal cervical cytology. Notably, the manual low‐cost liquid‐based Pap preparation is practical in this setting and offers an alternate method for local studies of HPV vaccine efficacy. Diagn. Cytopathol. 2010;38:555–563. 2009 Wiley‐Liss, Inc.