Human papillomavirus-type distribution in South African women without cytological abnormalities: a peri-urban study

Abstract

Objectives: Knowledge of human papillomavirus (HPV) distribution in the general population is crucial for the development of new HPV vaccines and to provide a baseline from which to monitor the impact of current HPV vaccines in the future. HPV-type distribution in the Tshwane area, South Africa, might be different to that in other regions and countries. Design: This was a retrospective descriptive study, representative of women without cervical cytological abnormalities. Setting and subjects: Women attending primary health clinics in the region of Tshwane were screened for cervical abnormalities with conventional cytology. Outcome measures: Women without cytological abnormalities were included, and HPV DNA typing, using HPV Linear^® Array Genotyping Test (Roche Molecular Systems, Branchburg, USA) was performed on all women. Results: Demographic data were available for 1 238 patients. The mean age was 40.9 years. The majority of the women (14.6%) were between 35 and 39 years of age. 19.4% of women were younger than 30 years of age. The prevalence of HPV types was 67.1% and high-risk HPV infections, 44.9%. The average number of HPV-type infections was 3.2 in the 845 patients with HPV infections. The most common high-risk virus was HPV 16 (10.8%), followed by HPV 51 (9.3%), and HPV 58 (7.9%). HPV 18 was observed in 5.9%, and HPV 45 in 7.5%, of participants. HPV 62 (15.6%) and HPV 84 (14.4%) were the most prevalent low-risk types. Conclusion: HPV infections were highly prevalent in this population. The prevalence of HPV 16 and 18 was higher than that reported in other world regions. HPV 16 was the most prevalent high-risk type infection in women without cytological abnormalities. HPV infections other than HPV 16 and 18 were also prevalent, and this is important for future vaccine development.