Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches
Persistent Human Papillomavirus (HPV) infection is a prerequisite for cervical cancer development. Few studies investigated clearance of high-risk HPV in low-and-middle-income countries. Our study investigated HPV clearance and persistence over four years in women from North Tongu District, Ghana.In...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-06-01
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| Series: | Papillomavirus Research |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405852118300958 |
| _version_ | 1811282315089805312 |
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| author | Amrei Krings Gifty Boateng Priscilla Dunyo Joseph E. Amuah Rashid A. Adams Lois Adunyame Dinah O. Nkansah Comfort M. Wormenor Benjamin T. Hansen Isaac Gedzah Richard H. Asmah Edwin K. Wiredu Andreas M. Kaufmann |
| author_facet | Amrei Krings Gifty Boateng Priscilla Dunyo Joseph E. Amuah Rashid A. Adams Lois Adunyame Dinah O. Nkansah Comfort M. Wormenor Benjamin T. Hansen Isaac Gedzah Richard H. Asmah Edwin K. Wiredu Andreas M. Kaufmann |
| author_sort | Amrei Krings |
| collection | DOAJ |
| description | Persistent Human Papillomavirus (HPV) infection is a prerequisite for cervical cancer development. Few studies investigated clearance of high-risk HPV in low-and-middle-income countries. Our study investigated HPV clearance and persistence over four years in women from North Tongu District, Ghana.In 2010/2011, cervical swabs of 500 patients were collected and HPV genotyped (nested multiplex PCR) in Accra, Ghana. In 2014, 104 women who previously tested positive for high-risk HPV and remained untreated were re-tested for HPV. Cytobrush samples were genotyped (GP5+/6+ PCR & Luminex-MPG readout) in Berlin, Germany. Positively tested patients underwent colposcopy and treatment if indicated.Of 104 women, who tested high-risk HPV+ in 2010/2011, seven (6,7%; 95%CI: 2.7–13.4%) had ≥1 persistent high-risk‐infection after ~4 years (mean age 39 years). Ninety-seven (93,3%; 95%CI: 86.6–97.3%) had cleared the original infection, while 22 (21.2%; 95%CI: 13.8–30.3%) had acquired new high-risk infections with other genotypes. Persistent types found were HPV 16, 18, 35, 39, 51, 52, 58, and 68. Among those patients, one case of CIN2 (HPV 68) and one micro-invasive cervical cancer (HPV 16) were detected.This longitudinal observational data suggest that single HPV screening rounds may lead to over-referral. Including type-specific HPV re-testing or additional triage methods could help reduce follow-up rates. Keywords: Persistence, Cervical screening, Natural history, LMIC, HPV screening |
| first_indexed | 2024-04-13T01:50:26Z |
| format | Article |
| id | doaj.art-2939e5531a304592b0320b067d2ee65b |
| institution | Directory Open Access Journal |
| issn | 2405-8521 |
| language | English |
| last_indexed | 2024-04-13T01:50:26Z |
| publishDate | 2019-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Papillomavirus Research |
| spelling | doaj.art-2939e5531a304592b0320b067d2ee65b2022-12-22T03:07:54ZengElsevierPapillomavirus Research2405-85212019-06-0174551Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approachesAmrei Krings0Gifty Boateng1Priscilla Dunyo2Joseph E. Amuah3Rashid A. Adams4Lois Adunyame5Dinah O. Nkansah6Comfort M. Wormenor7Benjamin T. Hansen8Isaac Gedzah9Richard H. Asmah10Edwin K. Wiredu11Andreas M. Kaufmann12Clinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, GermanyNational Public Health and Reference Laboratory, Korle Bu, Accra, GhanaCatholic Hospital Battor, Volta Region, GhanaSchool of Epidemiology & Public Health, University of Ottawa, CanadaSchool of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, GhanaSchool of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, GhanaSchool of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, GhanaCatholic Hospital Battor, Volta Region, GhanaCatholic Hospital Battor, Volta Region, GhanaCatholic Hospital Battor, Volta Region, GhanaSchool of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, GhanaSchool of Biomedical and Allied Health Sciences, University of Ghana College of Health Sciences, Korle Bu, Accra, GhanaClinic for Gynecology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany; Corresponding author.Persistent Human Papillomavirus (HPV) infection is a prerequisite for cervical cancer development. Few studies investigated clearance of high-risk HPV in low-and-middle-income countries. Our study investigated HPV clearance and persistence over four years in women from North Tongu District, Ghana.In 2010/2011, cervical swabs of 500 patients were collected and HPV genotyped (nested multiplex PCR) in Accra, Ghana. In 2014, 104 women who previously tested positive for high-risk HPV and remained untreated were re-tested for HPV. Cytobrush samples were genotyped (GP5+/6+ PCR & Luminex-MPG readout) in Berlin, Germany. Positively tested patients underwent colposcopy and treatment if indicated.Of 104 women, who tested high-risk HPV+ in 2010/2011, seven (6,7%; 95%CI: 2.7–13.4%) had ≥1 persistent high-risk‐infection after ~4 years (mean age 39 years). Ninety-seven (93,3%; 95%CI: 86.6–97.3%) had cleared the original infection, while 22 (21.2%; 95%CI: 13.8–30.3%) had acquired new high-risk infections with other genotypes. Persistent types found were HPV 16, 18, 35, 39, 51, 52, 58, and 68. Among those patients, one case of CIN2 (HPV 68) and one micro-invasive cervical cancer (HPV 16) were detected.This longitudinal observational data suggest that single HPV screening rounds may lead to over-referral. Including type-specific HPV re-testing or additional triage methods could help reduce follow-up rates. Keywords: Persistence, Cervical screening, Natural history, LMIC, HPV screeninghttp://www.sciencedirect.com/science/article/pii/S2405852118300958 |
| spellingShingle | Amrei Krings Gifty Boateng Priscilla Dunyo Joseph E. Amuah Rashid A. Adams Lois Adunyame Dinah O. Nkansah Comfort M. Wormenor Benjamin T. Hansen Isaac Gedzah Richard H. Asmah Edwin K. Wiredu Andreas M. Kaufmann Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches Papillomavirus Research |
| title | Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches |
| title_full | Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches |
| title_fullStr | Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches |
| title_full_unstemmed | Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches |
| title_short | Dynamics of genotype-specific HPV clearance and reinfection in rural Ghana may compromise HPV screening approaches |
| title_sort | dynamics of genotype specific hpv clearance and reinfection in rural ghana may compromise hpv screening approaches |
| url | http://www.sciencedirect.com/science/article/pii/S2405852118300958 |
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