Département de Médecine Sociale et Préventive, Université Laval, Québec, QC, Canada.
Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada.
PLoS One. 2020 Nov 25;15(11):e0242711. doi: 10.1371/journal.pone.0242711. eCollection 2020.
This study aimed to: (1) Estimate HPV prevalence and genotype distribution among female sex workers (FSWs) in Mali and Benin as well as the prevalence of multiple HPV type infections in this group, and (2) Identify potential risk factors associated with high-risk (HR) HPV infections.
We analyzed baseline data of 665 FSWs aged ≥ 18 years recruited during a prospective cohort of cervical cancer screening in Cotonou (Benin) and Bamako (Mali) from 2017 to 2018. The Linear Array HPV genotyping test was used to identify HPV genotypes. Descriptive statistics and multivariate log-binomial regression were used. Adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) were estimated to identify risk factors associated with HR-HPV infections.
HPV data were available for 659 FSWs (Benin: 309; Mali: 350). The mean age was 35.0 years (± 10.7) in Benin and 26.8 years (± 7.6) in Mali. The overall HPV prevalence rates were 95.5% in Benin and 81.4% in Mali. About 87.7% and 63.4% of FSWs harbored ≥ 2 HPV types in Benin and Mali, respectively. The top three prevalent HR-HPV among FSWs in Benin were: HPV58 (37.5%), HPV16 (36.6%) and HPV52 (28.8%). Corresponding patterns in Mali were HPV16 (15.7%), HPV51 (14.3%) and HPV52 (12.9%). In Benin, the main factors associated with HR-HPV were vaginal douching (APR = 1.17; 95%CI:1.02-1.34) and gonococcal infection (APR = 1.16; 95%CI:1.04-1.28), while in Mali they were sex work duration ≤ 1 year (APR = 1.35; 95%CI:1.10-1.65) and HIV infection (APR = 1.26; 95%CI: 1.06-1.51).
Our study found a very high prevalence of HPV infection as well as high frequency of multiple HPV type infections in FSWs in two countries in West Africa. These findings suggest the necessity to emphasize cervical cancer prevention in this high-risk group.
本研究旨在：（1）评估马里和贝宁的女性性工作者（FSW）中 HPV 的流行率和基因型分布，以及该人群中多种 HPV 型感染的流行率；（2）确定与高危（HR）HPV 感染相关的潜在风险因素。
我们分析了 2017 年至 2018 年期间在贝宁科托努和马里巴马科进行的宫颈癌筛查前瞻性队列中招募的 665 名年龄≥18 岁的 FSW 的基线数据。使用 Linear Array HPV 基因分型检测来确定 HPV 基因型。采用描述性统计和多变量对数二项式回归进行分析。估计调整后的患病率比（APR）及其 95%置信区间（95%CI），以确定与 HR-HPV 感染相关的风险因素。
FSW 的 HPV 数据可用于 659 名 FSW（贝宁：309；马里：350）。贝宁的平均年龄为 35.0 岁（±10.7），马里为 26.8 岁（±7.6）。贝宁的 HPV 总流行率为 95.5%，马里为 81.4%。贝宁和马里分别有 87.7%和 63.4%的 FSW 携带≥2 种 HPV 类型。贝宁 FSW 中最常见的三种 HR-HPV 是 HPV58（37.5%）、HPV16（36.6%）和 HPV52（28.8%）。马里对应的模式是 HPV16（15.7%）、HPV51（14.3%）和 HPV52（12.9%）。在贝宁，与 HR-HPV 相关的主要因素是阴道冲洗（APR = 1.17；95%CI：1.02-1.34）和淋球菌感染（APR = 1.16；95%CI：1.04-1.28），而在马里，与 HR-HPV 相关的主要因素是性工作持续时间≤1 年（APR = 1.35；95%CI：1.10-1.65）和 HIV 感染（APR = 1.26；95%CI：1.06-1.51）。
我们的研究发现，在西非的两个国家中，FSW 的 HPV 感染率非常高，且 HPV 多种类型感染的频率也很高。这些发现表明，有必要在高危人群中强调宫颈癌的预防。
