Epidemiology and Health

Systematic Review

Prevalence of high-risk HPV genotypes in sub-Saharan Africa according to HIV status: a 20-year systematic review: Jude Ogechukwu Okoye, Chukwudi Amaechi Ofodile, Oluwaseun Kelechi Adeleke, Okechi Obioma; Epidemiol Health. 2021;43:e2021039. Published online May 25, 2021; DOI: https://doi.org/10.4178/epih.e2021039

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Abstract

OBJECTIVES
This review assessed the rate of high-risk human papillomavirus (HPV) infection among women living in sub-Saharan Africa. It also determined the prevalence of high-risk HPV (hrHPV) among human immunodeficiency virus (HIV) seropositive (HIV+) and seronegative (HIV-) women in sub-Saharan Africa, pre-2010 and post-2010.

METHODS

In this systematic review, Google Scholar, PubMed Central, and Embase were searched to identify cohort and case-control studies that investigated the relationship between HIV and HPV infection. The database searches yielded 17 studies published between 1999 and 2018.

RESULTS

In the general population, the prevalence of any HPV/multiple HPV infections was higher among HIV+ (53.6/22.6%) than among HIV- women (26.5/7.3%) with odds ratios of 3.22 and 3.71, respectively (95% confidence interval, 3.00 to 3.42 and 2.39 to 5.75, p< 0.001). The prevalent HPV genotypes among HIV+ and HIV- women diagnosed with invasive cervical cancer (ICC) were HPV-16/18 and HPV-45. The prevalence of HPV-16, HPV-18, and HPV-45 was lower in 1999-2010 (3.8, 1.7, and 0.8%, respectively) than in 2011-2018 (19.1, 6.0, and 3.6%, respectively). Among women diagnosed with ICC, HIV+ women had a higher prevalence of HPV-56, HPV-31, and HPV-51 (7.3, 5.3, and 3.3%, respectively) than HIV- women (1.3, 2.2, and 0.4%, p< 0.001, p= 0.050, and p= 0.013, respectively).

CONCLUSIONS

The prevalence of HPV infection, multiple HPV infections, and non-vaccine HPV types were higher among HIV+ women than among HIV- women in sub-Saharan Africa. Although HIV infection influences the distribution of HPV types, this study suggests that cervical cancer incidence in sub-Saharan Africa is primarily driven by the prevalence of vaccine hrHPVs, especially HPV-16 and HPV-18.

Summary

Key Message
Despite increasing awareness of Human papillomavirus (HPV) among women and availability of HPV vaccines, mounting evidence shows that the age-standardized incidence rate of cervical cancer is increasing in sub-Saharan Africa. This review revealed the influences of some viruses on the trends of the disease between 1999-2010 and 2011-2018.

Citations

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Health Statistics

Changing trends in the incidence (1999-2011) and mortality (1983-2013) of cervical cancer in the Republic of Korea: Yoon Park, Champadeng Vongdala, Jeongseon Kim, Moran Ki; Epidemiol Health. 2015;37:e2015024. Published online May 29, 2015; DOI: https://doi.org/10.4178/epih/e2015024

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246 Download
20 Web of Science
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Abstract Summary PDF

Abstract

Cervical cancer is a well-known preventable cancer worldwide. Many countries including Korea have pursued the positive endpoint of a reduction in mortality from cervical cancer. Our aim is to examine changing trends in cervical cancer incidence and mortality after the implementation of a national preventive effort in Korea. Cervical cancer incidence data from 1999 to 2011 and mortality data from 1983 to 2013 were collected from the Korean Statistical Information Service. Yearly age-standardized rates (ASR) per 100,000 were compared using two standards: the 2005 Korean population and the world standard population, based on Segi’s world standard for incidence and the World Health Organization for mortality. In Korea, the age-standardized incidence of cervical cancer per 100,000 persons declined from 17.2 in 2000 to 11.8 in 2011. However, the group aged 25 to 29 showed a higher rate in 2011 (ASR, 6.5) than in 2000 (ASR, 3.6). The age-standardized mortality rate per 100,000 persons dropped from 2.81 in 2000 to 1.95 in 2013. In the worldwide comparison, the incidence rates remained close to the average incidence estimate of more developed regions (ASR, 9.9). The decreasing mortality trend in Korea approached the lower rate observed in Australia (ASR, 1.4) in 2010. Although the incidence rate of cervical cancer is continuously declining in Korea, it is still high relative to other countries. Moreover, incidence and mortality rates in females aged 30 years or under have recently increased. It is necessary to develop effective policy to reduce both incidence and mortality, particularly in younger age groups.

Summary

Korean summary
한국의 자궁경부암 발생률과 사망률은 꾸준히 감소하고 있는 추세이다. 그러나 한국의 발생률은 여러 선진국에 비해 여전히 높은 수준에 머무르고 있다. 또한, 지난 10년 동안 자궁경부암 사망률은 상대적으로 큰 감소를 보이지 않았다. 특히 35세 미만에서는 자궁경부암 발생률이 감소하지 않았고, 사망률은 오히려 높아진 것으로 나타났다. 젊은 연령층의 자궁경부암 예방과 관리가 필요하다.

Citations

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