Abstract:
OBJECTIVES : Cervical cancer is the most common cause of cancer-related deaths among
South African women. Viral types associated with cervical cancer may differ not only
between countries and regions, but possibly also between human immunodeficiency virus
(HIV)Yinfected and noninfected women.
METHODS : In a population with high HIV prevalence, human papillomavirus (HPV)Ytype
infections detected with DNA analyses were reported in a cohort of 299 women diagnosed
with invasive cervical cancer.
RESULTS : One hundred fifty-four women tested HIV negative, 77 tested HIV positive, and
HIVstatuswas unknown for 68women. Themean age forHIV-positivewomenwas 41.3 years,
and that for HIV-negative women was 55.8 years (P G 0.001). Ninety-two percent of women
tested HPV-DNA positive. Human papillomavirus types 16 and/or 18 were present in 62%
of HIV-negative women and 65% of HIV-positive women. The 5 most common HPV types
in HIV-positive women were, in decreasing frequency, HPV 16, 18, 45, 33, and 58. In HIVnegative
women, the most common HPV types were HPV 16, 18, 35, and 45, followed by
HPV 33 and 52.Human papillomavirus type 45wasmore likely in the HIV positive compared
with theHIV negative (odds ratio, 3.07; 95%confidence interval, 1.07Y8.77).TheHIV-positive
women had more multiple high-risk HPV-type infections than did the HIV-negative women
(27% vs 8%, P = 0.001).
CONCLUSIONS : A high number of women in South Africa with cervical cancer are HIV
positive. Without viral cross-protection, HPV vaccines should prevent around 65% of
cervical cancers in this population. Human papillomavirus type 45 infection is significantly
linked to HIV and important for future vaccine developments.
