Document Type
Article
Department
Obstetrics and Gynaecology (East Africa)
Abstract
Objectives Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).
Methods Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical swabs was performed (Roche Cobas Assay); all WLWH underwent cervical biopsy on two occasions.
Results Of 114 WLWH enrolled, the median age was 38.2 years. All WLWH were receiving ART during the study. CIN2/3 was found in 13 (11.4 %) WLWH; HPV 16 was detected in 10 (8.8 %); HPV 18 in 11 (9.6 %), and Non-16/18 HR-HPV in 62 (54.4 %). Aflatoxin exposure was not associated with CIN2/3 in this analysis. A multivariable logistic regression found that cervical detection of HPV 18 was significantly associated with CIN2/3 (OR = 6.36, 95 % CI = 1.36–29.75, p = 0.019), after adjusting for the effects of HIV viral load, CD4 counts, and Non-16/18 HR-HPV detection.
Conclusions CIN2/3 was detected in 11.4% of WLWH; HPV 18 detection in cervical swabs was strongly associated with CIN2/3. Larger studies among WLWH are needed to determine optimal approaches for screening and treatment to prevent cervical cancer.
Publication (Name of Journal)
Gynecologic Oncology Reports
DOI
https://doi.org/10.1016/j.gore.2025.101953
Recommended Citation
Nakalembe, M.,
Mpamani, C.,
Namugga, J.,
Nakisige, C.,
Banturaki, G.,
Tonui, P.,
Itsura, P.,
Orang'o, E.,
Muthoka, K.,
Ngeresa, A.
(2025). Cervical HPV 18 detection is associated with high-grade cervical dysplasia in Kenyan and Ugandan women living with HIV. Gynecologic Oncology Reports, 61, 1-6.
Available at:
https://ecommons.aku.edu/eastafrica_fhs_mc_obstet_gynaecol/758
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.