Prevalence, Characteristics, and Distribution of Human Papillomavirus According to Age and HIV Status in Women of Eastern Cape Province, South Africa

Human papillomavirus (HPV) is the most sexually transmitted infection associated with the development of cervical cancer. This study investigated cervical HPV prevalence, characteristics and distribution according to age and human immunodeficiency virus (HIV) among women attending public community health facility in the Eastern Cape Province of South Africa. A total of 325 participants (aged 18 to 60) visiting a community health facility for any reason were recruited. Cervical HPV infection was detected using the Seegene Anyplex™ II HPV28 assay. Overall HPV prevalence was 65.2% (95% CI: 59.9–70.2%), with the highest prevalence of 80.9% (95% CI: 67.2–89.8%) observed in the 18–25 years age group and lowest prevalence of 46.3% (95% CI: 35.8–57.1%) in 46–60 years of age. HR-HPV infection was found to decrease with increasing age among women who were HPV infected by any type (p=0.02), but not when stratified according to HIV status. A proportion of 12.9% (42/325) were infected with one or more HPV types covered by the Cervarix® HPV vaccine (HPV-16 and/or -18), 18.8% (61/325) by those covered by Gardasil®4 (HPV-6, -11, -16 and/or -18) and 42.2% (137/325) by those covered by Gardasil®9 (HPV-6, -11, -16, -18, -31, -33, -45, -52 and/or -58). Alpha-9 HPV species were the most dominant species (40.6%, 132/325), followed by alpha-7 species (29.8%, 97/325). In the overall population, alpha-9 HPV species were always part of the most dominant HPV alpha species co-infection, which were alpha-9 and -7 species (17.5%, 57/325), alpha-9 and -5 species (9.8%, 32/325), and alpha-9 and -6 species (9.5%, 31/325). High overall HPV, HR-HPV, and alpha-9 species prevalence were observed among women attending the public health facility. These findings contribute to the limited HPV distribution data among Eastern Cape women, which could be used to improve HPV-related policy and assess the effectiveness of the HPV vaccination.