Prevalence of Human Papillomavirus and Genotype Correlation with Cervical Lesions at the University Teaching Hospital of Kigali.

Abstract

Cervical cancer remains a major health problem, especially in low- and middle-income countries (LMICs), with human papillomavirus (HPV) infection serving as the primary precursor. Despite global efforts to combat cervical cancer, including vaccination, a critical knowledge gap persists regarding HPV prevalence, genotype distribution, and their correlation with cervical lesions in LMICs. This study has assessed the prevalence of HPV infection, identified the most common HPV genotypes, and evaluated their correlation with cervical lesions at the University Teaching Hospital of Kigali, Rwanda. A total of 473 women were screened for HPV infection, with further evaluation of cervical lesions in HPV-positive women. The overall HPV prevalence was 74 of 473 (15.6%), with the highest concentration among women aged 41-45 years (29.7%). HPV genotypes 16 and 18 were most prevalent (7.6% each). Cyto-histological examination showed 23.6% cancerous lesions and 37.2% benign lesions in women with HPV-positive results. Women with high-risk HPV (HR-HPV) infections had a 2.67-fold increased risk of developing cancerous lesions compared with those with low-risk HPV infections (95% CI: 1.08-6.58, P = 0.033). Notably, 21.6% of HPV-positive women were also HIV-positive, highlighting the coinfection of these two viruses. In conclusion, this study demonstrates a varied distribution of HPV genotypes among Rwandan women and a significant association between HR-HPV types and cervical lesions. These findings emphasize the need for tailored cervical cancer prevention strategies, including targeted surveillance, vaccination, and enhanced screening in Rwanda and similar resource-limited settings.