Background Human papillomavirus (HPV) types 6 and 11 are known agents of genital warts but little is known about their epidemiology in Africa.
Objective To present data on the prevalence of, and risk factors for, cervical HPV 6 and 11 in high-risk women in Burkina Faso.
Methods 306 women were enrolled. HIV status and CD4+ counts were determined. Among other genital samples, a cervical swab (Cervex) was collected for liquid-based cytology and HPV genotyping using MY09/MY11 and GP5+/GP6+ PCRs, and INNO-LiPA genotyping v2. Risk factors were examined using logistic regression.
Results HIV-1 seroprevalence was 40% (123/306). Cervical HPV DNA was detected in 55% (100/183) of HIV-uninfected women, 84% (78/93) of HIV-1 infected women with CD4+ T-cell counts >200 cells/μl and 97% (29/30) of HIV-1 infected women with CD4+ T-cell counts ≤200 cells/μl (ptrend<0.001). HPV 6 prevalence was 6% (18/306), HPV 11 prevalence 4% (13/306), and overall HPV 6/11 prevalence 9% (28/306), which increased with HIV infection and immunosuppression. Genital warts were associated with HPV 6 (adjusted OR=4.12, 95% CI 1.17 to 14.53) but not with HPV 11. Genital ulcerations were associated with HPV 6/11 but not with other HPV types. There was a protective effect for vaginal douching and the follicular phase of the menstrual cycle. Condom use, HIV-1 plasma viral load and sexually transmitted and other reproductive tract infections were not associated with HPV 6/11.
Conclusions Prevalence of HPV 6/11 was high in this population, with predominance of HPV 6. HPV 6/11 were found more frequently in women with genital ulcers and in those with HIV-related immunosuppression.
- Low-risk human papillomavirus (LR-HPV)
- genital warts
- genital ulcer disease
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Funding This study was funded by France's Agence Nationale de Recherches sur le SIDA et les Hépatites (ANRS), grants ANRS-1291 and ANRS-1285. Additional financial support was provided through the UK's Department for International Development (DFID)-funded Knowledge Programme on HIV/AIDS and STI, and the Research Programme Consortia (RPC) on Research and Capacity Building in Sexual and Reproductive Health and HIV in Developing Countries of the London School of Hygiene and Tropical Medicine. The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of DFID.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the ethics committees of Centre Muraz and Burkina Faso, and of the London School of Hygiene and Tropical Medicine.
Provenance and peer review Not commissioned; externally peer reviewed.