High Risk Human Papillomavirus (Hr-HPV) Prevalence and Genotypes Detected in Women ≥ 30 Years Old who have Never been Screened for Cervical Cancer in Harare, Zimbabwe

Background: Almost 50% of all cervical cancer cases are diagnosed in patients who have never been screened for cervical cancer before. There is an established cause - effect relationship between Hr-HPV infection and cervical cancer. Therefore, knowing the prevalence and high risk HPV genotype distribution in this group of women helps to formulate vaccination policies in a country. There is paucity of such information in Zimbabwean women.

Aim: To determine high risk HPV prevalence and genotypes in women who have never been screened for cervical cancer. To compare HPV positivity rates between women of ages’ <30 and ≥30 years.

Study Design: Cross sectional descriptive study.

Place and Duration of Study: Cimas Medical Laboratories. Between January 2017 to December 2019.

Methodology: High risk HPV DNA screening was done using the Cepheid Xpert HPV qualitative screening test. Specimens positive for the pooled HPV subtypes were further typed using the HPV Genotypes 14 Real-TM Quant test kit to characterize specific subtypes. A t –test was used to compare the HPV positivity rates between women of ages’ <30 and ≥30 years. A p-value <0.05 was regarded as statistically significant.

Results: The HPV positivity rates were 20% and 31% in women of ages’ ≥30 and <30 years respectively. There was a statistically significant difference in HPV positivity between these two groups (p=0.03). HPV 52 was the most common subtype (15.8%) followed by HPV 18 (14.3%), HPV 16 (11.9%), HPV 35 (9.5%) and HPV33 & 58 which both contributed 8.3% of all subtypes detected.

Conclusions: Approximately 20% of women 30 years old and above have an HPV infection. HPV 52, 18 and 16 are the most common HPV subtypes in Zimbabwe.

Recommendation: HPV 52 should be included in the vaccines currently being used in Zimbabwe which are predominantly composed of HPV 16 and 18.