abstract: 'BackgroundFor women living with HIV (WLHIV), the burden of persistent

  HPV infection, cervical pre-cancerous lesions and cancer have been

  demonstrated to be higher than among HIV-negative women. As Ghana and

  other lower-middle-income countries (LMIC) work toward developing

  national cervical cancer programmes, it is essential that local

  scientific evidence be provided to guide policy decisions, especially

  for such special populations. The objective of this study was to

  determine the distribution of high-risk HPV genotype and related factors

  among WLHIV and its implication for the prevention of cervical cancer

  prevention efforts.MethodsA cross-sectional study was conducted at the

  Cape Coast Teaching Hospital in Ghana. WLHIV, aged 25-65 years, who met

  the eligibility criteria were recruited through a simple random sampling

  method. An interviewer-administered questionnaire was used to gather

  socio-demographic, behavioural, clinical and other pertinent

  information. The AmpFire HPV detection system (Atila BioSystem, Mointain

  View, CA was used to detect 15 high-risk HPV genotypes from

  self-collected cervico-vaginal samples. The data collected were exported

  to STATA 16.0 for statistical analysis.ResultsIn all, 330 study

  participants, with mean age of 47.2 years (SD +/- 10.7), were involved.

  Most (69.1\%, n = 188/272) had HIV viral loads < 1000 copies/ml and

  41.2\% (n = 136) had ever heard of cervical screening. The overall

  hr-HPV prevalence was 42.7\% (n = 141, 95\% CI 37.4-48.1) and the five

  commonest hr-HPV types among screen positives were HPV59 (50.4\%), HPV18

  (30.5\%), HPV35 (26.2\%), HPV58 (17\%) and HPV45 (14.9\%). Most infected

  women (60.3\%, n = 85) had multiple hr-HPV infections, with about 57.4\%

  (n = 81) having 2-5 h-HPV types, while 2.8\% (n = 4) had more than five

  hr-HPV types. A total of 37.6\% (n = 53) had HPV16 and/or18, while

  66.0\% (n = 93) had the hr-HPV genotypes covered by the nonavalent

  vaccine. Women with HIV viral load >= 1000copies/ml (AOR = 5.58, 95\% CI

  2.89-10.78, p < 0.001) had a higher likelihood of being

  co-infected.ConclusionThis study found out that the prevalence of hr-HPV

  still remains high in women with HIV, with a notable occurrence of

  multiple infections and infection with genotypes 16 and/or18.

  Additionally, an association was established between hr-HPV and

  infection HIV viral load.. Therefore, comprehensive HIV care for these

  women should include awareness of cervical cancer, consideration of

  vaccination and implementation of screening and follow-up protocols.

  National programmes in LMIC, such as Ghana, should consider using

  HPV-based screen-triage-treat approach with partial genotyping.'
affiliation: 'Obiri-Yeboah, D (Corresponding Author), Cape Coast Teaching Hosp, Publ
  Hlth Unit, Cape Coast, Ghana.

  Obiri-Yeboah, D (Corresponding Author), Univ Cape Coast, Sch Med Sci, Dept Microbiol
  \& Immunol, Cape Coast, Ghana.

  Akakpo, Patrick Kafui; Derkyi-Kwarteng, Leonard, Univ Cape Coast, Sch Med Sci, Dept
  Anat Pathol, Cape Coast, Ghana.

  Ken-Amoah, Sebastian, Univ Cape Coast, Sch Med Sci, Dept Obstet \& Gynaecol, Cape
  Coast, Ghana.

  Enyan, Nancy Innocentia Ebu, Univ Cape Coast, Sch Nursing \& Midwifery, Dept Adult
  Hlth, Cape Coast, Ghana.

  Agyare, Elizabeth; Baidoo, Ibrahim; Obiri-Yeboah, Dorcas, Cape Coast Teaching Hosp,
  Publ Hlth Unit, Cape Coast, Ghana.

  Agyare, Elizabeth; Salia, Emmanuel; Obiri-Yeboah, Dorcas, Univ Cape Coast, Sch Med
  Sci, Dept Microbiol \& Immunol, Cape Coast, Ghana.

  Asare, Matthew, Baylor Univ, Robbins Coll Hlth \& Human Serv, Dept Publ Hlth, Waco,
  TX USA.

  Adjei, George, Univ Cape Coast, Sch Med Sci, Dept Community Med, Cape Coast, Ghana.

  Addo, Stephen Ayisi, Korle Bu, Natl AIDS STIs Control Programme, Accra, Ghana.'
article-number: '33'
author: Akakpo, Patrick Kafui and Ken-Amoah, Sebastian and Enyan, Nancy Innocentia
  Ebu and Agyare, Elizabeth and Salia, Emmanuel and Baidoo, Ibrahim and Derkyi-Kwarteng,
  Leonard and Asare, Matthew and Adjei, George and Addo, Stephen Ayisi and Obiri-Yeboah,
  Dorcas
author-email: dobiri-yeboah@ucc.edu.gh
author_list:
- family: Akakpo
  given: Patrick Kafui
- family: Ken-Amoah
  given: Sebastian
- family: Enyan
  given: Nancy Innocentia Ebu
- family: Agyare
  given: Elizabeth
- family: Salia
  given: Emmanuel
- family: Baidoo
  given: Ibrahim
- family: Derkyi-Kwarteng
  given: Leonard
- family: Asare
  given: Matthew
- family: Adjei
  given: George
- family: Addo
  given: Stephen Ayisi
- family: Obiri-Yeboah
  given: Dorcas
da: '2023-09-28'
doi: 10.1186/s13027-023-00513-y
files: []
issn: 1750-9378
journal: INFECTIOUS AGENTS AND CANCER
keywords: HPV; HIV; Ghana; Cervical cancer; Screening; Resource-limited settings
keywords-plus: 'INTRAEPITHELIAL NEOPLASIA; INFECTION; PREVALENCE; WORLDWIDE; MORTALITY;

  KNOWLEDGE; BARRIERS; AFRICA'
language: English
month: MAY 26
number: '1'
number-of-cited-references: '72'
orcid-numbers: 'Salia, Emmanuel/0009-0009-8607-9410

  Agyare, Elizabeth/0000-0002-1696-474X'
papis_id: 64f06d5d41e732397a565a8d775c5db4
ref: Akakpo2023highriskhuman
times-cited: '0'
title: High-risk human papillomavirus genotype distribution among women living with
  HIV; implication for cervical cancer prevention in a resource limited setting
type: article
unique-id: WOS:000994189000001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '18'
web-of-science-categories: Oncology; Immunology
year: '2023'