High-risk human papillomavirus genotype distribution among women living with and at risk for HIV in Africa.

OBJECTIVE: Cervical cancer is a common preventable cancer among African women living with HIV (WLWH). Molecular diagnostics for high-risk human papillomavirus (HR-HPV) genotypes are standard components of cervical cancer screening in resource-rich countries but not in resource-limited settings. We evaluated HR-HPV genotypes among women with and without HIV in four African countries to inform cervical cancer preventive strategies. METHODS: The African Cohort Study (AFRICOS) enrolled participants with and without HIV at 12 clinics in Tanzania, Kenya, Uganda, and Nigeria. Cervical cytobrush specimens from women were genotyped for 14 HR-HPV types using the multiplex Seegene Anyplex real-time PCR assay. Robust Poisson regression was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) for factors associated with HR-HPV in WLWH. RESULTS: From January 2015 to March 2020, 868 WLWH and 134 women living without HIV (WLWoH) were tested for HR-HPV with prevalence of 50.9 and 38.1%, respectively ( P  = 0.007). Among WLWH, 844 (97.4%) were antiretroviral therapy (ART)-experienced and 772 (89.7%) virally suppressed 1000 copies/ml or less. The most frequent HR-HPV types among WLWH were HPV-16 (13.5%), HPV-52 (9.5%), and HPV-35 (9.3%). HR-HPV infection was more common among Tanzanian WLWH (adjusted RR: 1.23, 95% CI 1.05-1.44, P  = 0.012). Also, WLWH with CD4 + T cells of less than 200 cell/µl had 1.51-fold increased risk of having HR-HPV (95% CI 1.23-1.86, P  < 0.001). CONCLUSION: HR-HPV was common in WLWH in four African countries, particularly among women with low CD4 + cell count. Scale up of HPV vaccines and development of vaccines with broader activity against less common HR-HPV types may improve cervical cancer prevention in Africa.

Histopathological patterns and topographical distribution of Kaposi Sarcoma at Muhimbili National Hospital, Tanzania.

Background: Kaposi sarcoma (KS) is derived from endothelial cell lineage; it is caused by Human Herpes Virus-8 (HHV-8) facilitated by immune suppression. KS remains one of the commonest sarcoma seen in Tanzania. The paucity of recent data makes monitoring the disease a challenge. This study describes the Histopathological Patterns and Topographical distribution of Kaposi Sarcoma at Muhimbili National Hospital, a tertiary care hospital in Tanzania. Methods: A hospital-based retrospective cross-sectional study was done to review biopsies sent to the Central Pathology Laboratory (CPL), Muhimbili National Hospital from 2010 to 2014. Results: A total of 818 cases representing 1.8 % of all malignancies during the study period were enrolled in the study. The age of patients at diagnosis ranged from 6 months to 94 years old, with the median age being 37 years. Male to female ratio was 1.4:1.0. Females were younger than males (p < 0.001). The majority of the lesions were in the lower limbs, 352 (64.1 %). Nodular KS accounted for 74.5% of all cases. Conclusion: Kaposi's sarcoma remains a common malignancy. The patients present late at diagnosis. Early diagnosis and improved treatment protocols remain to be key steps towards reducing the burden of KS.