Document Type



Obstetrics and Gynaecology (East Africa)


Background: Cervical cancer is caused by oncogenic human papillomaviruses (HR-HPV) and is common among Kenyan women. Identifcation of factors that increase HR-HPV persistence is critically important. Kenyan women exposed to afatoxin have an increased risk of HR-HPV detection in cervical specimens. This analysis was performed to examine associations between afatoxin and HR-HPV persistence.

Methods: Kenyan women were enrolled in a prospective study. The analytical cohort for this analysis included 67 HIVuninfected women (mean age 34 years) who completed at least two of three annual study visits and had an available blood sample. Plasma afatoxin was detected using ultra-high pressure liquid chromatography (UHPLC)-isotope dilution mass spectrometry. Annual cervical swabs were tested for HPV (Roche Linear Array). Ordinal logistic regression models were ftted to examine associations of afatoxin and HPV persistence. Results Afatoxin was detected in 59.7% of women and was associated with higher risk of persistent detection of any HPV type (OR=3.03, 95%CI=1.08–8.55, P=0.036), HR-HPV types (OR=3.63, 95%CI=1.30-10.13, P=0.014), and HRHPV types not included in the 9-valent HPV vaccine (OR=4.46, 95%CI=1.13–17.58, P=0.032).

Conclusions: Afatoxin detection was associated with increased risk of HR-HPV persistence in Kenyan women. Further studies, including mechanistic studies are needed to determine if afatoxin synergistically interacts with HR-HPV to increase cervical cancer risk


This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

BMC Infectious Diseases


Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.