The effects of genital Schistosoma haematobium on human papillomavirus and the development of cervical neoplasia after five years in a zimbabwean population

TY - JOUR

T1 - The effects of genital Schistosoma haematobium on human papillomavirus and the development of cervical neoplasia after five years in a zimbabwean population

AU - Kjetland, E.F.

AU - Ndhlovu, P.D.

AU - Mduluza, T.

AU - Deschoolmeester, V.

AU - Midzi, N.

AU - Gomo, E.

AU - Gwanzura, L.

AU - Mason, P.R.

AU - Vermorken, J.B.

AU - Friis, Henrik

AU - Gundersen, S.G.

AU - Baay, M.F.D.

PY - 2010

Y1 - 2010

N2 - Background: High-risk human papillomavirus (HPV) is responsible for cervical cancer and genital Schistosoma haematobium infection has been hypothesized to be an additional co-factor or even an independent risk factor for cervical neoplasia. The present study aimed to investigate the impact of schistosomiasis on HPV persistence and development of cell atypia in a group of rural Zimbabwean women with confirmed high-risk HPV. Methods: A five-year follow-up was done among women previously included in a study on genital schistosomiasis. Women who had high-risk HPV at baseline were invited after 5 years for examination of cell atypia, genital schistosomiasis, and high-risk HPV. Both vaginal lavage samples (low-cost) and cervix brush samples (high-cost) were obtained for further analysis. Results: Thirty-seven women were re-examined. Genital Schistosoma haematobium of a minimum of five years' duration was associated with the development high-grade squamous intraepithelial neoplasia, but not with persistent high-risk HPV. There was a high concordance between the brush and vaginal lavage (96.3% agreement, kappa 0.93); however, the number of β-globin negative vaginal lavage samples was unacceptably high. Conclusions: Findings warrant an exploration in a larger longitudinal study where a vaginal swab should be explored.

AB - Background: High-risk human papillomavirus (HPV) is responsible for cervical cancer and genital Schistosoma haematobium infection has been hypothesized to be an additional co-factor or even an independent risk factor for cervical neoplasia. The present study aimed to investigate the impact of schistosomiasis on HPV persistence and development of cell atypia in a group of rural Zimbabwean women with confirmed high-risk HPV. Methods: A five-year follow-up was done among women previously included in a study on genital schistosomiasis. Women who had high-risk HPV at baseline were invited after 5 years for examination of cell atypia, genital schistosomiasis, and high-risk HPV. Both vaginal lavage samples (low-cost) and cervix brush samples (high-cost) were obtained for further analysis. Results: Thirty-seven women were re-examined. Genital Schistosoma haematobium of a minimum of five years' duration was associated with the development high-grade squamous intraepithelial neoplasia, but not with persistent high-risk HPV. There was a high concordance between the brush and vaginal lavage (96.3% agreement, kappa 0.93); however, the number of β-globin negative vaginal lavage samples was unacceptably high. Conclusions: Findings warrant an exploration in a larger longitudinal study where a vaginal swab should be explored.

M3 - Journal article

SN - 0392-2936

VL - 31

SP - 169

EP - 173

JO - European Journal of Gynecological Oncology

JF - European Journal of Gynecological Oncology

IS - 2

ER -