Background/Aims: In Zimbabwe, cervical cancer is screened through cytology and visual inspection with acetic acid and cervicography (VIAC). The effectiveness of these methods can be increased if complemented by a human papillomavirus DNA detection tool since most cervical cancer cases are caused by persistent infection with high-risk human papillomavirus (HR-HPV) genotypes. Moreover, the possibility of multiple-genotype HR-HPV infections warrants the need for HPV detection tools with the capacity to detect both single and multiple infections. The aim of this study was to detect HR-HPV genotypes (HPV 16, 18, 31, 33, 35, 45, 51, 52, 56, and 58), using multiplex polymerase chain reaction (PCR), in stored cervicovaginal swabs from both HIV-positive and HIV-negative women reporting for routine cervical cancer screening. Methodology: Stored cervicovaginal swabs from sexually active women who underwent VIAC at the Parirenyatwa Referral Hospital in Harare, Zimbabwe, between February and April 2015 and had received HIV counselling and testing were genotyped for the selected 10 HR-HPV genotypes using in-house multiplex PCR. The results from the multiplex PCR were compared to those previously obtained when the same samples were HPV genotyped with next-generation sequencing (NGS) on an MiSeq platform (Illumina; USA). Results: A total of 136 women were recruited and all 10 HR-HPV genotypes were detected. Quality control failed in 3 of the 136 swabs during the multiplex PCR reactions. The prevalence of HR-HPV genotypes in the study subjects was 53% (70/133). HIV-infected women were 1.67 times more likely to be infected with HR-HPV than were HIV-negative women (OR 1.67; p = 0.17). Of the 70 HR-HPV-positive cases, 37% (26/70) had multiple HR-HPV infections, and the majority of them were HIV infected. HIV-infected women were 1.86 times more likely to have multiple HR-HPV infections than HIV-negative women (OR 1.86; p = 0.20). Multiplex PCR and NGS had an almost perfect concordance rate in -HR-HPV detection (κ = 0.960), with only 3 discordant cases (negative with NGS and positive for HPV16 with multiplex PCR). Conclusion: Multiplex PCR can detect HR-HPV genotypes that are common in Zimbabwe and could be used to detect HR-HPV genotypes from women attending cervical cancer screening programs at the Parirenyatwa VIAC clinic in Harare.

1.
Chin’ombe
N
,
Sebata
NL
,
Ruhanya
V
,
Matarira
HT
.
Human papillomavirus genotypes in cervical cancer and vaccination challenges in Zimbabwe
.
Infect Agent Cancer
.
2014
May
;
9
(
1
):
16
.
[PubMed]
1750-9378
2.
Kuguyo
O
,
Matimba
A
,
Tsikai
N
,
Magwali
T
,
Madziyire
M
,
Gidiri
M
, et al.
Cervical cancer in Zimbabwe: a situation analysis
.
[Internet]
.
Pan Afr Med J
.
2017
Jul
;
27
:
215
. [cited 2017 Dec 25] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622829/
[PubMed]
1937-8688
3.
Schim van der Loeff
MF
,
Mooij
SH
,
Richel
O
,
de Vries
HJ
,
Prins
JM
.
HPV and anal cancer in HIV-infected individuals: a review
.
Curr HIV/AIDS Rep
.
2014
Sep
;
11
(
3
):
250
62
.
[PubMed]
1548-3568
4.
Denny
L
.
Control of cancer of the cervix in low- and middle-income countries
.
Ann Surg Oncol
.
2015
Mar
;
22
(
3
):
728
33
.
[PubMed]
1068-9265
5.
World Health Organization
. African coalition on maternal, newborn and child health. Africa cervical cancer multi indicator incidence and mortality scorecard.
2014
. Cancer Profile In Zimbabwe [Internet]. [cited 2019 Mar 12]. Available from: http://www.zimcancerregistry.co.zw/cancer-profile-in-zimbabwe.html
6.
Cancer Profile In Zimbabwe [Internet]. [cited 2019 Mar 12]. Available from: http://www.zimcancerregistry.co.zw/cancer-profile-in-zimbabwe.html.
7.
Moscicki
AB
,
Ellenberg
JH
,
Farhat
S
,
Xu
J
.
Persistence of human papillomavirus infection in HIV-infected and -uninfected adolescent girls: risk factors and differences, by phylogenetic type
.
J Infect Dis
.
2004
Jul
;
190
(
1
):
37
45
.
[PubMed]
0022-1899
8.
Dube Mandishora
RS
,
Christiansen
IK
,
Chin’ombe
N
,
Duri
K
,
Ngara
B
,
Rounge
TB
, et al.
Genotypic diversity of anogenital human papillomavirus in women attending cervical cancer screening in Harare, Zimbabwe
.
J Med Virol
.
2017
Sep
;
89
(
9
):
1671
7
.
[PubMed]
0146-6615
9.
Multiplex PCR Guidelines for Multiplex PCR 5X Master Mix | NEB [Internet]. [cited 2019 Mar 12]. Available from: https://international.neb.com/protocols/2012/09/13/multiplex-pcr-guidelines-for-multiplex-pcr-5x-master-mix-m0284
10.
Romero-Pastrana
F
.
Detection and typing of human papilloma virus by multiplex PCR with type-specific primers
.
ISRN Microbiol
.
2012
Mar
;
2012
:
186915
.
[PubMed]
2090-7478
11.
Bruni
L
,
de Sanjosé
S
,
Barrionuevo-Rosas
L
,
Serrano
B
.
Mena, Bosch FX, et al. Human Papillomavirus and Related Diseases in Zimbabwe. Summary Report. ICO/IARC Information Centre on HPV and Cancer
.
HPV Information Centre
;
2017
.
12.
Chirara
M
,
Stanczuk
GA
,
Tswana
SA
,
Nystrom
L
,
Bergstrom
S
,
Moyo
SR
, et al.
Low risk and high risk human papillomaviruses (HPVs) and cervical cancer in Zimbabwe: epidemiological evidence
.
Cent Afr J Med
.
2001
Feb
;
47
(
2
):
32
5
.
[PubMed]
0008-9176
13.
Matuvhunye
T
,
Dube-Mandishora
RS
,
Chin’ombe
N
,
Chakafana
G
,
Mbanga
J
,
Zumbika
E
, et al.
Genotyping Human Papillomavirus in Women Attending Cervical Cancer Screening Clinic in Harare, Zimbabwe
.
Br Microbiol Res J
.
2016
Aug
;
16
(
6
):
1
9
. 2231-0886
14.
Rousseau
M
,
Pereira
JS
,
Prado
JC
.
Cervical co-infection with human papillomavirus (HPV) as a predictor of acquisition and persistence of other HPV types
.
J Infect Dis
.
2001
;
184
:
1508
17
.
[PubMed]
0022-1899
15.
Strickler
HD
,
Burk
RD
,
Fazzari
M
,
Anastos
K
,
Minkoff
H
,
Massad
LS
, et al.
Natural history and possible reactivation of human papillomavirus in human immunodeficiency virus-positive women
.
J Natl Cancer Inst
.
2005
Apr
;
97
(
8
):
577
86
.
[PubMed]
0027-8874
16.
Bello
BD
,
Spinillo
A
,
Alberizzi
P
,
Cesari
S
,
Gardella
B
,
D’Ambrosio
G
, et al.
Cervical infections by multiple human papillomavirus (HPV) genotypes: prevalence and impact on the risk of precancerous epithelial lesions
.
J Med Virol
.
2009
Apr
;
81
(
4
):
703
12
.
[PubMed]
0146-6615
17.
Nilyanimit
P
,
Chansaenroj
J
,
Poomipak
W
,
Praianantathavorn
K
,
Payungporn
S
,
Poovorawan
Y
.
Comparison of Four Human Papillomavirus Genotyping Methods: Next-generation Sequencing, INNO-LiPA, Electrochemical DNA Chip, and Nested-PCR
.
Ann Lab Med
.
2018
Mar
;
38
(
2
):
139
46
.
[PubMed]
2234-3806
18.
WHO
. | WHO leads the way towards the elimination of cervical cancer as a public health concern [Internet]. WHO. [cited 2019 Jun 1]. Available from: http://www.who.int/reproductivehealth/cervical-cancer-public-health-concern/en/
19.
Konopnicki
D
,
De Wit
S
,
Clumeck
N
.
HPV and HIV coinfection: a complex interaction resulting in epidemiological, clinical and therapeutic implications
.
Future Virol
.
2013
Aug
;
8
(
9
):
903
15
. 1746-0794
20.
Herald
T
. First Lady launches HPV vaccination programme [Internet]. The Herald. [cited 2018 Jul 7]. Available from: https://www.herald.co.zw/first-lady-launches-hpv-vaccination-programme/
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.