Abstract:

Background and Objectives: Cancer of the cervix is the second most common cause of cancer related deaths in Sub-Saharan Africa including Tanzania. Human Papilloma virus has been implicated as causative agent of cervical cancer. However, there is limited data in Tanzania on the prevalence of HPV and genotypes distribution among HIV infected women. This study aimed at investigating prevalence of HPV and genotype distribution among HIV – infected women at Bugando Medical Centre, Mwanza Tanzania.

Methods: A cross sectional hospital based study involving 255 HIV infected women was conducted between August and October, 2014. Exfoliated cells from ectocervix and endocervix were collected using cytobrush. HPV genotypes were detected by polymerase chain reaction (PCR) and sequencing using primers targeting sequances which are conserved among a broad range of HPV types. Cytology was done to study morphological changes associated with HPV infection as well as to establish SIL.

Results: The mean age of enrolled women was 39.2±9.1 years. Of all enrolled women, 138 (15.1%, 95% CI: 47-60) were found to have HPV DNA. Twenty six genotypes were detected in various combinations; of these 17(67.3%) were of high risk genotypes. High risk genotypes were detected in 124(48.6%) of HIV positive women. The common high risk genotypes detected were HPV– 52(26), HPV-58(21), HPV-35(20), and HPV-16(14). Squamous intraepithelial lesions was significantly associated with HPV infection (p<0.001). The odds of being HPV positive were significantly higher among women with CD4 counts <100 (OR: 3.4, 95% CI: 1.2-9.7, P=0.026) and those with good socioeconomic status (OR: 1.83, 95% CI: 1.09-3.72, P=0.023) in the multivariate analysis.

Conclusion: Significant proportion of HIV positive women with low CD4 counts and good socioeconomic status in Mwanza have various grades of cervical dysplasia associated with varieties of high risk HPV genotypes. This calls for the need to evaluate the efficacy of the current vaccine in preventing cervical cancer particularly in developing countries where HIV is endemic.