Human papillomavirus in a rural community in Zimbabwe: the impact of HIV co-infection on HPV genotype distribution

J Med Virol. 2004 Jul;73(3):481-5. doi: 10.1002/jmv.20115.


Cervical cancer is a leading cause of cancer-related deaths in developing countries, and the human papillomavirus (HPV) is linked etiologically to cervical cancer. Hence, a vaccine which prevents HPV-associated cervical cancer would have the most impact in developing countries, including the African continent. The type-specific immune response towards HPV virus-like particles, in combination with geographical variation in the prevalence of HPV, necessitates the presence of multiple HPV type antigens in a single vaccine cocktail in order to provide relevant protection. We aimed to investigate whether co-infection with HIV, which is highly prevalent in Africa, plays a role in HPV genotype distribution. After informed consent, HPV detection by GP5+/6+ PCR and HIV detection by serology was carried out on 236 women from the rural north-western part of Zimbabwe. The prevalence of HPV was higher in HIV positive women (54%) than in HIV negative women (27%). Certain HPV types (HPV types 11, 39, 43, 51, and 59, P-values ranging from 0.017 to 0.067) occurred more frequently in HIV positive women. Only high-risk HPV, and not HIV, was associated significantly with cervical intraepithelial neoplasia in multiple regression analysis. In conclusion, a high prevalence of HPV was found in a rural community, where regular Papanicolaou (Pap) smears would be a logistic and economic impossibility, but where free vaccination programmes against other infections are already established. The results suggest that HIV co-infection may have an impact on HPV genotype distribution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • DNA, Viral / analysis
  • Female
  • Genotype
  • HIV Antibodies / blood
  • HIV Infections / complications*
  • Humans
  • Middle Aged
  • Papillomaviridae / genetics*
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / complications*
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / virology*
  • Polymerase Chain Reaction
  • Prevalence
  • Risk Factors
  • Rural Health*
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / virology
  • Vagina / virology
  • Vaginal Douching
  • Zimbabwe / epidemiology


  • DNA, Viral
  • HIV Antibodies