Tawe Leabaneng, Ramatlho Pleasure, Ketlametswe Rebecca, Koobotse Moses, Robertson Erle S, Grover Surbhi, Ramogola-Masire Doreen, Paganotti Giacomo M
Botswana-University of Pennsylvania Partnership, Gaborone, Botswana.
Office of Research and Graduate Studies, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
Front Med (Lausanne). 2022 Nov 24;9:1020760. doi: 10.3389/fmed.2022.1020760. eCollection 2022.
Cervical cancer burden is still high in low- and middle-income countries, including Botswana. Persistent human papillomavirus (HPV) infection is the leading cause of cervical cancer. Accurate knowledge of HPV diversity associated to cervical cancer in sub-Saharan Africa may provide accurate understanding of the natural history of HPV infection in these contexts. The goal of this review was to consolidate existing evidence on cervical HPV infection and to conduct a pooled analysis of data from all eligible Botswana studies. After a successful review of twelve studies on cervical HPV genotypes that met the inclusion criteria, HPV-16 genotype was the most frequently discovered in women with pre-cancerous and cancer lesions, followed by HPV-18. HPV-16 in HIV-positive women with precancerous lesions to cancer is between 45% and 47.7%, and between 4.5% and 26.1% for HPV-18. With reference to other HPV genotypes, the proportion of HPV-35 and HPV-58 (13-16%) seems relatively consistent among the studies, however HPV-58 appears to be more common in HIV-positive subjects compared to HIV-negative women. Indeed, HPV-45 seems to be frequently detected in women with cervical cancer compared to women with precancerous lesions. Regarding the low-risk HPV genotypes, an appropriate breakdown has been provided. In conclusion, the current prophylactic vaccines against HPV-16 and HPV-18, which have demonstrated good immunogenicity in HIV-infected populations, may still prevent infection and ultimately cancer.
在包括博茨瓦纳在内的低收入和中等收入国家,宫颈癌负担仍然很高。持续性人乳头瘤病毒(HPV)感染是宫颈癌的主要病因。准确了解撒哈拉以南非洲地区与宫颈癌相关的HPV多样性,有助于准确理解这些地区HPV感染的自然史。本综述的目的是整合现有的关于宫颈HPV感染的证据,并对博茨瓦纳所有符合条件的研究数据进行汇总分析。在成功检索到12项符合纳入标准的关于宫颈HPV基因型的研究后,发现HPV-16基因型在癌前病变和癌症病变女性中最为常见,其次是HPV-18。HPV-16在HIV阳性且有癌前病变至癌症的女性中的占比为45%至47.7%,HPV-18为4.5%至26.1%。关于其他HPV基因型,HPV-35和HPV-58的比例(13%-16%)在各项研究中似乎相对一致,然而与HIV阴性女性相比,HPV-58在HIV阳性受试者中似乎更为常见。事实上,与癌前病变女性相比,HPV-45似乎在宫颈癌女性中更常被检测到。对于低风险HPV基因型,也给出了适当的分类。总之,目前针对HPV-16和HPV-18的预防性疫苗在HIV感染人群中已显示出良好的免疫原性,可能仍可预防感染并最终预防癌症。