Age-specific prevalence of cervical human papillomavirus infection and cytological abnormalities in women in Gauteng Province, South Africa

摘要

BACKGROUND. Women accessing the public health system in Gauteng province, South Africa are largely unscreened for cervical cancer andhave a high background prevalence of human immunodeficiency virus (HIV) infection.OBJECTIVES. This cross-sectional study describes the age-specific prevalence of human papillomavirus (HPV) infection and cytologicalabnormalities among this urban and peri-urban population.METHOD. Over the period March 2009 - September 2011, 1 524 women attending public sector primary healthcare clinics were invited toparticipate in a cervical cancer screening study. All participants were screened with conventional cytology and HPV testing undertakenusing the HPV linear array genotyping kit (Roche Molecular Systems).RESULTS. Of 1 472 women with valid cytology results, abnormalities were detected in 17.3% (n=255), of which 9.1% (n=134) were high-gradesquamous intraepithelial lesions, and 0.5% (n=8) suggestive of squamous carcinoma. Of the 1 445 women with complete data, the overalland high-risk HPV DNA prevalences were 74.6% (n=1 078) and 54.3% (n=784), respectively. HPV type 16 and/or 18 were detected in 19.5%(n=282) of women. Age-specific prevalence of HPV showed a plateau-shaped curve.CONCLUSIONS. The prevalences of HPV infection and abnormal cytology were much higher than previously reported in general populationsin South Africa and elsewhere. Higher age-specific prevalence and similar plateau-like age-specific epidemiological curves have previouslyonly been described in studies among HIV-positive women. These findings have implications for planning and development of cervicalscreening programmes in developing countries with largely unscreened populations with a high background prevalence of HIV.