Factors Associated with Anogenital HPV Infection and Disease Prevalence, Incidence, Persistence: a Prospective Cohort Study
Project ended 31 March 2018
Prof Sinead Delany-Moretlwe
- Wits Reproductive and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand
Title of the project
Factors associated with anogenital HPV infection and disease prevalence, incidence, persistence: a prospective cohort study.
In an established cohort of 300 HIV positive men, of whom two thirds are currently on ART, we plan to extend follow up in these men from 12 to 24 months in order to assess factors that are associated with the incidence, persistence and progression of anogenital HPV infection and associated anal lesions. In addition, we aim to evaluate the association between HPV 16/18 genital viral loads in predicting anal cytological abnormality and progression of disease. With this application we request support for testing of 18 and 24 months samples for HPV DNA genotypes and HPV 16/18 viral load, anal cytology collected from this cohort.
How was the project of value in the struggle against cancer:
Our study showed that MLHIV men face a huge burden of anogenital HPV infection, with a third of men having persistent infection which puts them at increased risk of HPV related cancers such as penile, anal and oropharyngeal cancers. Overall, the study findings provide some evidence to support vaccination of boys as a consideration for policy. Men are a reservoir of HPV infection, therefore preventing them from infection would also protect women. Given the high HIV prevalence in South Africa, which might mean reduced impact and herd immunity of the girls’ only vaccination programme, the current vaccination programme would need to be extended to include boys. The current publicly funded HPV vaccination programme offers the two doses of the vaccine 6 months apart to grade 4 (aged 9-12) in schools.