Abstract:
Background: Persistent high-risk HPV infection is a leading cause of anal cancer, with women living with HIV at higher risk due to impaired viral clearance. Despite Rwanda's HPV vaccination program, the epidemiology of anal hr-HPV in WLWHIV remains poorly studied. This study aimed to determine the prevalence, genotype distribution associated with anal high-risk HPV infections in WLWHIV in Rwanda.
Methods: Archived anal swab samples from 300 WLWHIV, aged 22 to 33, and were analyzed at Rwanda Military Referral and Teaching Hospital Research Laboratory. Samples were processed using the Atila AmpFire HPV High-Risk Genotyping Kit, employing real-time isothermal amplification to detect hr-HPV genotypes. Statistical analysis using SPSS assessed hr-HPV prevalence, genotype distribution, and associations with demographic factors like age and vaccination status.
Results: The prevalence of high-risk anal HPV was 39.5%, with HPV56 being the most prevalent genotype, followed by HPV35, HPV18, and HPV53. Co-infections with multiple high-risk HPV types were common, particularly HPV39 with HPV51 and HPV39 with HPV66 as the most frequent combinations. No significant relationship was observed between hr-HPV positivity and age, vaccination status, suggesting that immunosuppression may have a more prominent role in the persistence of infection.
Conclusion: This study underscores the significant burden of high-risk anal HPV infections among women living with HIV in Rwanda, with a unique genotype distribution, including a high prevalence of non 16 and18 types. It highlights the need for targeted public health interventions, such as regular anal HPV screening and broader spectrum HPV vaccines, to ensure long-term prevention.
