# Prevalence and genotype distribution of cervical HPV among women living with and without HIV in selected health facilities in Limpopo province, South Africa

## TL;DR

This study found a higher prevalence of HPV among women with HIV in Limpopo, South Africa, highlighting the need for targeted screening and vaccination.

## Contribution

The study provides new data on HPV prevalence and genotype distribution in a region with limited prior information.

## Key findings

- HPV was detected in 32.7% of participants, with 52.21% prevalence among women living with HIV.
- High-risk HPV 45 was the most common genotype overall, while HPV 56 was more common in non-HIV women.
- Multiple infections and high-risk HPV genotypes were more frequent in women living with HIV.

## Abstract

High-risk alpha human papillomaviruses (HPVs) are associated with cervical cancer (CC).

This study investigated the prevalence and genotype distribution of HPV among women living with and without HIV in Limpopo province, South Africa.

The prevalence of HPV was determined in 450 participants who self-reported to be living with HIV or not. Total DNA was extracted from cervical specimens and amplified through a double-nested polymerase chain reaction (PCR) approach targeting a fragment of the L1 gene. A product from any of the nested PCRs was considered positive for the presence of HPV DNA. The first nested PCR products (~450 base pairs [bp]) were sequenced on an Illumina MiniSeq. Sequence reads of acceptable quality were analysed for viral genotypes.

Human papillomavirus was detected in 32.7% of the study participants and was significantly higher at 52.21% (p = 0.00) among women living with HIV (WLWH) as compared to those not living with HIV. Overall, high-risk (hr) HPV 45 was the predominant genotype (16.7%). However, low-risk (lr) HPV 81 (18.8%) and hr-HPV 56 (25.0%) were more common among women living with and without HIV, respectively. Multiple infections and hr-HPV genotypes were more common among WLWH.

A relatively high prevalence of HPV was detected in the cervical specimens from the study population. Women living with HIV were the most infected group. The data suggest that WLWH should be prioritised for HPV screening and vaccination.

This study contributes to the knowledge of HPV in Limpopo province, a region with scarce data on HPV epidemiology.