Cervical infection with human papillomavirus (HPV) 6 or 11 in high-risk women in Burkina Faso.

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 (p(trend)<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.