Mrema Alita, Ngoma Mamsau, Lugina Emmanuel L, Kahakwa Atukuzwe, Mwita Chacha Josiah, Iddy Salama, Rugengamizi Eulade, Samwel Kandali, Ngowi John, Lidenge Salum J, Wood Charles, Mwaiselage Julius
Department of Clinical Research Training and Consultancy, Ocean Road Cancer Institute, Dar es salaam, Tanzania.
Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
PLoS One. 2025 Aug 1;20(8):e0322311. doi: 10.1371/journal.pone.0322311. eCollection 2025.
Cervical cancer (CC) is the leading cancer among women in Tanzania, especially among those between the ages of 15 and 44. The prevalence of high-risk Human papillomavirus (HR-HPV)-16/18 women in the general population at any given time is 3.3%. HR-HPVs 16 or 18 are the primary cause of CC. The distribution of HPV genotypes among women with CC according to HIV status is unknown in Tanzania. This study aimed to determine the HPV genotype distribution according to HIV status among women with CC in Tanzania.
This cross-sectional study was done at Ocean Road Cancer Institute (ORCI) in Tanzania among women with histologically confirmed CC. HIV serology testing was performed. Biopsy was taken from cervical lesions, and DNA was extracted. HPV DNA was amplified by using a previously validated multiplex HPV PCR assay targeting 14 high-risk HPV genotypes (16,18,30,31,33, 35, 39, 45, 51, 52, 56, 58, 59, and 66) and two low-risk HPV genotypes (6 and 11). Continuous variables were compared using either a student t-test or the Mann-Whitney U test. Fisher's exact test was employed to compare discrete variables. A P-value less than 0.05 was considered statistically significant.
We included 100 women with CC. The prevalence of HIV infection in this study was 42%. The prevalence of any HPV infection was 94%, ranging from 1-3 genotypes per woman. HPV. The median age for women living with HIV (WLWH) with CC patients was 45 years (IQR, 31-60), while the median age for HIV-uninfected women with CC patients was 57 years (IQR, 30-78). (p = 0.0001). WLWH and HIV-uninfected women had similar HPV prevalence, except for HPV 35, which was more common in WLWH. There was a trend of high prevalence of HPV 52 and HPV 58 in WLHH compared to HIV-uninfected women, but this difference was not statistically significant. The prevalence of HPV 16 and/or 18 infection in the entire sample was 85%. The combined prevalence of HPV 16 and/or 18 was 76% WLWH and 91% amongst HIV-uninfected women (p = 0.036).The majority of women (77.9%) had single-genotype HPV infection. There was no difference in the distribution of multiple or single HPV genotypes infection by HIV status (p = 0.25).
In this study, HIV positive women with CC presented at a significantly younger age (45 years) compared to the HIV-negative women (57 years). The prevalence of high-risk HPV is high among women with CC in Tanzania. Distribution of most high-risk HPV genotypes among women with CC was not significantly influenced by HIV status except for HPV 35, which appeared to be more in HIV positive women compared to HIV-negative women. While the majority of the high-risk HPV infections were with single HPV genotypes, the prevalence of multiple high-risk HPV infections was at 22%, with no significant difference between the two HIV statuses. A vaccination program that aptly targets HPV 16 and 18 could prevent up to 85% of CC cases in Tanzania, regardless of HIV. Keywords: Human papillomavirus, cervical cancer, HIV, Tanzania.
宫颈癌（CC）是坦桑尼亚女性中的主要癌症，尤其是在15至44岁的女性中。在任何给定时间，普通人群中高危型人乳头瘤病毒（HR-HPV）-16/18感染女性的患病率为3.3%。HR-HPV 16或18是宫颈癌的主要病因。在坦桑尼亚，根据艾滋病毒感染状况，宫颈癌女性中HPV基因型的分布情况尚不清楚。本研究旨在确定坦桑尼亚宫颈癌女性中根据艾滋病毒感染状况的HPV基因型分布。
本横断面研究在坦桑尼亚的海洋路癌症研究所（ORCI）对组织学确诊为宫颈癌的女性进行。进行了艾滋病毒血清学检测。从宫颈病变处取活检组织并提取DNA。使用先前验证的多重HPV PCR检测法扩增HPV DNA，该检测法针对14种高危HPV基因型（16、18、30、31、33、35、39、45、51、52、56、58、59和66）和两种低危HPV基因型（6和11）。连续变量使用学生t检验或曼-惠特尼U检验进行比较。采用Fisher精确检验比较离散变量。P值小于0.05被认为具有统计学意义。
我们纳入了100名宫颈癌女性。本研究中艾滋病毒感染的患病率为42%。任何HPV感染的患病率为94%，每位女性感染1 - 3种基因型。感染宫颈癌的艾滋病毒感染者（WLWH）的中位年龄为45岁（四分位间距，31 - 60岁），而未感染艾滋病毒的宫颈癌女性的中位年龄为57岁（四分位间距，30 - 78岁）（p = 0.0001）。除HPV 35在艾滋病毒感染者中更常见外，艾滋病毒感染者和未感染艾滋病毒的女性的HPV患病率相似。与未感染艾滋病毒的女性相比，艾滋病毒感染者中HPV 52和HPV 58的患病率有升高趋势，但这种差异无统计学意义。整个样本中HPV 16和/或18感染的患病率为85%。HPV 16和/或18的合并患病率在艾滋病毒感染者中为76%，在未感染艾滋病毒的女性中为91%（p = 0.036）。大多数女性（77.9%）为单基因型HPV感染。艾滋病毒感染状况对多基因型或单基因型HPV感染的分布没有差异（p = 0.25）。
在本研究中，感染宫颈癌的艾滋病毒阳性女性（45岁）的年龄明显低于艾滋病毒阴性女性（57岁）。在坦桑尼亚，宫颈癌女性中高危HPV的患病率很高。除HPV 35外，在感染宫颈癌的女性中，大多数高危HPV基因型的分布受艾滋病毒感染状况的影响不显著，与未感染艾滋病毒的女性相比，HPV 35在艾滋病毒阳性女性中似乎更多见。虽然大多数高危HPV感染为单基因型，但多重高危HPV感染的患病率为22%，两种艾滋病毒感染状况之间无显著差异。一个恰当地针对HPV 16和18的疫苗接种计划可以预防坦桑尼亚高达85%的宫颈癌病例，无论艾滋病毒感染状况如何。关键词：人乳头瘤病毒、宫颈癌、艾滋病毒、坦桑尼亚
