Human papillomavirus infection in women with and without cervical cancer in Ibadan, Nigeria

Infectious Agents and Cancer - Tập 5 Số 1 - 2010
Clement Abu Okolo1, Silvia Franceschi2, Isaac F. Adewole1, J Thomas1, Michele Follen3, Peter J.F. Snijders4, Chris J.L.M. Meijer4, Gary M. Clifford2
1College of Medicine, University of Ibadan, Ibadan, Nigeria
2International Agency for Research on Cancer, Lyon, France
3Drexel University, College of Medicine, Philadelphia, Pennsylvania, USA.
4VU University Medical Center, Amsterdam, The Netherlands

Tóm tắt

Abstract Background

Concerns have been raised that the proportion of cervical cancer preventable by human papillomavirus (HPV) 16/18 vaccines might be lower in sub-Saharan Africa than elsewhere.

Method

In order to study the relative carcinogenicity of HPV types in Nigeria, as well as to estimate the vaccine-preventable proportion of invasive cervical cancer (ICC) in the Country, we compared HPV type prevalence among 932 women from the general population of Ibadan, Nigeria, with that among a series of 75 ICC cases diagnosed in the same city. For all samples, a GP5+/6+ PCR based assay was used for the detection of 44 genital HPV types.

Results

In the general population, 245 (26.3%, 95% confidence interval (CI) 23.5% - 29.2%) women were HPV-positive, among whom the prevalence of HPV35 and HPV16 were equally frequent (12.2%, 95% CI 8.4% - 17.0%). In ICC, however, HPV16 predominated strongly (67.6% of 68 HPV-positive cases), with the next most common types being 18 (10.3%, 95% CI 4.2% - 20.1%), 35, 45 and 56 (each 5.9%, 95% CI 1.6% - 14.4%). Comparing among HPV-positive women only, HPV16 and 18 were over-represented in ICC versus the general population (prevalence ratios 5.52, 95% CI 3.7 - 8.3 and 1.4, 95% CI 0.6 - 3.3, respectively). Other high-risk HPV types, as well as low-risk and multiple HPV infections were less common in HPV-positive women with ICC than from the general population.

Conclusions

Our study confirms that in Nigeria, as elsewhere, women infected with HPV16 and 18 are at higher risk of developing ICC than those infected with other high-risk types, and that current HPV16/18 vaccines have enormous potential to reduce cervical cancer in the region.

Từ khóa


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