Human papillomavirus prevalence in a population of women living in Port-au-Prince and Leogane, Haiti.

BACKGROUND:There have been no published studies of carcinogenic human papillomavirus (HPV)--the necessary cause of cervical cancer--in Haiti, a nation that has one of the greatest burdens of cervical cancer globally. OBJECTIVE:Characterize prevalence of carcinogenic HPV and the prevalence of individual carcinogenic HPV genotypes in women with cervical precancer or cancer, cervical intraepithelial neoplasia grade 2 (CIN2) or more severe (CIN2+). METHODS:Women (n=9,769; aged 25-60 years) were screened for carcinogenic HPV by Hybrid Capture 2 (HC2; Qiagen, Gaithersburg, MD). Carcinogenic HPV positives underwent colposcopy and visible lesions were biopsied. A subset of carcinogenic HPV positives was tested for individual HPV genotypes using a GP5+/6+ assay. RESULTS:The prevalence of carcinogenic HPV was 19.0% (95% confidence interval: 18.4%-19.9%) and decreased with increasing age (ptrend < 0.001). Women with 3 or more sexual partners and who started sex before the age of 18 years had twice the age-adjusted prevalence of carcinogenic HPV of women with one partner and who started sex after the age of 21 (24.3% vs. 12.9%, respectively). HPV16 and HPV35 were the most common HPV genotypes detected in CIN2+ and more common in women with CIN2+ than those without CIN2+. HPV16 and/or HPV18 were detected in 21.0% of CIN2 (n = 42), 46.2% of CIN3 (n = 52), and 80% of cancers (n = 5). CONCLUSIONS:The prevalence of carcinogenic HPV in Haiti was much greater than the prevalence in other Latin American countries. High carcinogenic HPV prevalence and a lack of cervical cancer screening may explain the high burden of cervical cancer in Haiti

Carcinogenic HPV prevalence by age range.

<p>The age-group specific prevalence of carcinogenic human papillomavirus (HPV) DNA as detected by Hybrid Capture 2 (HC2). Bars represent 95% confidence intervals .</p

Age-range-specific carcinogenic HPV prevalence in Latin America compared to Haiti.

<p>A comparison of carcinogenic HPV prevalence for selected cross-sectional studies conducted in Latin America: Haiti (from this study); Guanacaste [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B16" target="_blank">16</a>]; Colombia [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B17" target="_blank">17</a>], Argentina [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B18" target="_blank">18</a>], Chile [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B17" target="_blank">17</a>], Mexico [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B17" target="_blank">17</a>]; Peru [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B18" target="_blank">18</a>]; Guatemala [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B20" target="_blank">20</a>]; and a second study from Mexico [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0076110#B19" target="_blank">19</a>]. *estimated from graphs; †Drs. Eduardo Franco and Luisa Villa, unpublished data, Ludwig-McGill Cohort, Brazil.</p