Epidemiology of HPV Genotypes among HIV Positive Women in Kenya: A Systematic Review and Meta-Analysis.

BACKGROUND: There is a scarcity of data on the distribution of human papillomavirus (HPV) genotypes in the HIV positive population and in invasive cervical cancer (ICC) in Kenya. This may be different from genotypes found in abnormal cytology. Yet, with the advent of preventive HPV vaccines that target HPV 16 and 18, and the nonavalent vaccine targeting 90% of all ICC cases, such HPV genotype distribution data are indispensable for predicting the impact of vaccination and HPV screening on prevention. Even with a successful vaccination program, vaccinated women will still require screening to detect those who will develop ICC from other High risk (HR) HPV genotypes not prevented by current vaccines. The aim of this review is to report on the prevalence of pHR/HR HPV types and multiple pHR/HR HPV genotypes in Kenya among HIV positive women with normal, abnormal cytology and ICC. METHODS: PUBMED, EMBASE, SCOPUS, and PROQUEST were searched for articles on HPV infection up to August 2nd 2016. Search terms were HIV, HPV, Cervical Cancer, Incidence or Prevalence, and Kenya. RESULTS: The 13 studies included yielded a total of 2116 HIV-infected women, of which 89 had ICC. The overall prevalence of pHR/HR HPV genotypes among HIV-infected women was 64% (95%CI: 50%-77%). There was a borderline significant difference in the prevalence of pHR/HR HPV genotypes between Female Sex workers (FSW) compared to non-FSW in women with both normal and abnormal cytology. Multiple pHR/HR HPV genotypes were highly prominent in both normal cytology/HSIL and ICC. The most prevalent HR HPV genotypes in women with abnormal cytology were HPV 16 with 26%, (95%CI: 23.0%-30.0%) followed by HPV 35 and 52, with 21% (95%CI: 18%-25%) and 18% (95%CI: 15%-21%), respectively. In women with ICC, the most prevalent HPV genotypes were HPV 16 (37%; 95%CI: 28%-47%) and HPV 18 (24%; 95%CI: 16%-33%). CONCLUSION: HPV 16/18 gains prominence as the severity of cervical disease increases, with HPV 16/18 accounting for 61% (95%CI: 50.0%-70.0%) of all ICC cases. A secondary prevention program will be necessary as this population harbors multiple pHR/HR HPV co-infections, which may not be covered by current vaccines. A triage based on FSW as an indicator may be warranted.

[Clinical analysis of 99 young patients with lung cancer in different nationalities in Xinjiang].

BACKGROUND: To study clinicopathological characteristics and national distribution of lung cancer in patients who were younger than 40 years of age in Xinjiang. METHODS: The records of 99 patients who were younger than 40 years of age with lung cancer who were diagnosed in our hospital from September, 1989 to July, 2001 were reviewed. Analyses as to gender, nationalities, misdiagnosis and pathological types were performed. RESULTS: The female had higher prevalence than the male did, the ratio of male to female was 1.75 to 1. The Han race had higher prevalence than other races did. Most of the patients had clinical manifestations (97.0%). Adenocarcinoma and small cell lung cancer were predominant histologic types, which accounted for about 71.1%. The misdiagnostic rate was 61.6%. CONCLUSIONS: In young patients with lung cancer, the diffe-rence of incidence between different genders is smaller than that in senile patients. The prevalence of lung can-cer in young people varies in different races in Xinjiang and Han race has the highest prevalence. The malignancy of lung cancer in young patients is high, and most cases are in advanced stage. The misdiagnostic rate is high.