Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique.

IF 2.8 2区医学 Q3 IMMUNOLOGY

Infectious Agents and Cancer Pub Date : 2025-04-14 DOI:10.1186/s13027-025-00655-1

Cristina Mendes de Oliveira, Ricardina Rangeiro, Nafissa Osman, Ellen Baker, Andrea Neves, Arlete A N Mariano, Guilhermina Tivir, Joseph P Thomas, Jennifer Carns, Viviane Andrade, Carla Carrilho, Eliane C S Monteiro, Hannah Hoover, Edson Chivambo, Marcos Chissano, Elizabeth Chiao, Hira Atif, Philip E Castle, Rebecca Richards-Kortum, Eva Lathrop, Kathleen M Schmeler, Cesaltina Lorenzoni, Mila P Salcedo

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Abstract

Background: Limited data are available about the distribution of human papillomavirus (HPV) among women undergoing cervical cancer screening in Mozambique. We describe the prevalence of high-risk HPV risk groups detected in women who participated in the MULHER Study, a prospective trial of Mozambican women undergoing cervical cancer screening with HPV testing.

Methods: From January 2020 to January 2023, 9,014 women aged 30-49 years in Maputo City and Gaza Province, Mozambique underwent cervical cancer screening. Cervicovaginal samples were self-collected (97.5%) or provider-collected (2.5%) and primary HPV testing was performed using the GeneXpert HPV testing platform (Cepheid Inc, USA) which provided data on HR-HPV risk groups: HPV16, HPV18/45 and 11 other HR-HPV types in aggregate. Women with a positive HR-HPV test underwent visual assessment using dilute acetic acid applied to the cervix for treatment decisions.

Results: Of the 9,014 women enrolled in the MULHER Study, 8,954 (99.3%) had a valid HPV test result. Of those, 2,805 (31.3%) tested positive for at least one HR-HPV group: HPV16 (n = 475, 16.9%), HPV18/45 (n = 686, 24.6%) and other HR-HPV (n = 2,150, 77.1%). A total of 17.8% were positive for multiple HPV HR groups. HR-HPV infection prevalence was higher among women living with HIV (WLWH) than HIV-negative women (39.7% vs. 24.3% respectively; p < 0.001). WLWH were more likely to test positive for HPV18/45 (p = 0.03) and for two or more HR-HPV risk groups (P < 0.0001) compared with HIV-negative women. HPV16 was the most frequently detected HR-HPV group (56.7%) among women diagnosed with invasive cervical cancer.

Conclusions: HR-HPV prevalence was high among Mozambican women aged 30-49 years, especially among WLWH, consistent with the high burden of cervical cancer in this population. HPV16 was the most common HR-HPV group among women with cervical cancer. Further study is needed to determine the role of HR-HPV genotyping in follow-up and treatment in Mozambique.

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在莫桑比克参加乳母宫颈癌筛查研究的妇女中评估hpv危险群体。

背景：关于人乳头瘤病毒（HPV）在莫桑比克接受宫颈癌筛查的妇女中的分布的数据有限。我们描述了在参加MULHER研究的妇女中检测到的高危HPV危险组的流行情况，MULHER研究是一项莫桑比克妇女接受宫颈癌筛查和HPV检测的前瞻性试验。方法：2020年1月至2023年1月，莫桑比克马普托市和加沙省的9014名30-49岁的妇女进行了宫颈癌筛查。宫颈阴道样本自行收集（97.5%）或由提供者收集（2.5%），使用GeneXpert HPV检测平台（美国Cepheid公司）进行初步HPV检测，该平台提供了HR-HPV危险组的数据：HPV16、HPV18/45和其他11种HR-HPV类型。HR-HPV检测阳性的妇女使用稀释醋酸涂抹宫颈进行目视评估以决定治疗方案。结果：在参加MULHER研究的9014名女性中，8954名（99.3%）有有效的HPV检测结果。其中2805例（31.3%）至少检测出一种HR-HPV组阳性：HPV16 (n = 475, 16.9%), HPV18/45 （n = 686, 24.6%）和其他HR-HPV （n = 2150, 77.1%）。共有17.8%的人多发HPV HR组阳性。HIV感染妇女（WLWH）的HR-HPV感染率高于HIV阴性妇女（分别为39.7%和24.3%）；结论：30-49岁的莫桑比克妇女中HR-HPV患病率很高，特别是在产妇中，这与该人群中宫颈癌的高负担一致。HPV16是宫颈癌妇女中最常见的HR-HPV组。需要进一步研究确定HR-HPV基因分型在莫桑比克随访和治疗中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infectious Agents and Cancer ONCOLOGY-IMMUNOLOGY

CiteScore

5.80

自引率

2.70%

发文量

期刊介绍： Infectious Agents and Cancer is an open access, peer-reviewed online journal that encompasses all aspects of basic, clinical, epidemiological and translational research providing an insight into the association between chronic infections and cancer. The journal welcomes submissions in the pathogen-related cancer areas and other related topics, in particular: • HPV and anogenital cancers, as well as head and neck cancers; • EBV and Burkitt lymphoma; • HCV/HBV and hepatocellular carcinoma as well as lymphoproliferative diseases; • HHV8 and Kaposi sarcoma; • HTLV and leukemia; • Cancers in Low- and Middle-income countries. The link between infection and cancer has become well established over the past 50 years, and infection-associated cancer contribute up to 16% of cancers in developed countries and 33% in less developed countries. Preventive vaccines have been developed for only two cancer-causing viruses, highlighting both the opportunity to prevent infection-associated cancers by vaccination and the gaps that remain before vaccines can be developed for other cancer-causing agents. These gaps are due to incomplete understanding of the basic biology, natural history, epidemiology of many of the pathogens that cause cancer, the mechanisms they exploit to cause cancer, and how to interrupt progression to cancer in human populations. Early diagnosis or identification of lesions at high risk of progression represent the current most critical research area of the field supported by recent advances in genomics and proteomics technologies.