Université de Paris, IAME, INSERM, F-75018 Paris, France; AP-HP, Hôpital Bichat, DEBRC, F-75018 Paris, France.
Université de Lomé, Faculté des Sciences de la Santé, Département de Santé Publique, Lomé, Togo; Centre Africain de Recherche en Epidémiologie et en Santé Publique (CARESP), Lomé, Togo; ISPED, Université de Bordeaux & Centre INSERM U1219 - Bordeaux Population Health, Bordeaux, France.
Clin Microbiol Infect. 2019 Dec;25(12):1560.e1-1560.e7. doi: 10.1016/j.cmi.2019.04.015. Epub 2019 Apr 30.
Sub-Saharan Africa is a region with high incidence of both human immunodeficiency virus (HIV) and cervical cancer. We conducted the first national study in Togo to assess prevalence of human papillomavirus (HPV), HIV and other sexually transmitted infections (STIs) among female sex workers (FSW).
A multicentric cross-sectional study was conducted among FSW recruited in hot spots (clubs, streets) in four Togolese cities. HPV and STIs were tested from cervical and anal swabs. HIV and syphilis were screened with rapid tests.
In all, 310 FSW were recruited; HIV and cervical high-risk HPV (hrHPV) prevalence were 10.6% (33/310) and 32.9% (102/310), respectively. The most frequent hrHPV types were HPV58 (13.6%, 19/140), HPV35 (12.9%, 18/140), HPV31 (12.1%, 17/140) and HPV16 (10.7%, 15/140). Prevalence of hrHPV and multiple hrHPV infections showed higher rates in HIV-positive than in HIV-negative FSW (48.5% versus 31.0%, p 0.04 and 21.2% versus 9.0%, p 0.03; respectively). Prevalence of hrHPV was higher in cervical than anal swabs (34.1% versus 20.7%, p 0.0004). High-risk HPV anal infections were more frequent among HIV-positive than HIV-negative FSW (51.9% versus 17.3%, p 2 × 10). Concomitant anal and cervical hrHPV infections were present in 43.2% (41/95) of hrHPV-positive FSW. Overall prevalence in the cervix of Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium and Trichomonas vaginalis were 4.2%, 6.1%, 5.5% and 6.5%, respectively.
This first African study on paired cervical and anal samples showed a high prevalence of genital HPV infections with a rather high rate of concomitant HPV infections but low type concordance. We report an unusual distribution of hrHPV types. These findings highlight the critical need for implementation of a national HPV vaccination strategy.
撒哈拉以南非洲地区是艾滋病毒（HIV）和宫颈癌高发地区。我们在多哥进行了首次全国性研究，以评估女性性工作者（FSW）中人类乳头瘤病毒（HPV）、HIV 和其他性传播感染（STI）的流行情况。
在多哥四个城市的热点地区（俱乐部、街头）招募 FSW 进行多中心横断面研究。从宫颈和肛门拭子中检测 HPV 和 STI。使用快速检测筛查 HIV 和梅毒。
共招募了 310 名 FSW；HIV 和宫颈高危型 HPV（hrHPV）的患病率分别为 10.6%（33/310）和 32.9%（102/310）。最常见的 hrHPV 类型是 HPV58（13.6%，19/140）、HPV35（12.9%，18/140）、HPV31（12.1%，17/140）和 HPV16（10.7%，15/140）。与 HIV 阴性 FSW 相比，HIV 阳性 FSW 的 hrHPV 和多重 hrHPV 感染率更高（48.5%比 31.0%，p=0.04；21.2%比 9.0%，p=0.03）。宫颈拭子中 hrHPV 的患病率高于肛门拭子（34.1%比 20.7%，p<0.0004）。与 HIV 阴性 FSW 相比，HIV 阳性 FSW 中高危 HPV 肛门感染更为常见（51.9%比 17.3%，p=2×10）。在 43.2%（41/95）的 hrHPV 阳性 FSW 中，同时存在宫颈和肛门的 hrHPV 感染。淋病奈瑟菌、沙眼衣原体、生殖支原体和阴道毛滴虫在宫颈的总患病率分别为 4.2%、6.1%、5.5%和 6.5%。
这是第一项关于宫颈和肛门配对样本的非洲研究，结果显示生殖道 HPV 感染率较高，同时 HPV 感染率较高，但 HPV 类型一致性较低。我们报告了一种不寻常的高危型 HPV 类型分布。这些发现突出表明迫切需要实施国家 HPV 疫苗接种策略。
