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J. Clin. Microbiol. doi:10.1128/JCM.01322-07
Copyright (c) 2007, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Cervical Human Papillomavirus (HPV) Infection and HPV type 16 Antibodies in South African Women

Institute of Infectious Disease and Molecular Medicine and Division of Medical Virology, Dept Clinical Laboratory Sciences, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town, South Africa.; School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, Cape Town South Africa; National Health Laboratory Services, Groote Schuur Hospital, Observatory, Cape Town, South Africa

^* To whom correspondence should be addressed. Email: di.marais{at}uct.ac.za.

	Abstract

There is a high incidence of cervical cancer in South African women. No large studies to assess HPV infection or HPV-16 exposure have occurred in the region, a requirement for policy making with regards HPV screening and the introduction of vaccines

Control women (n=1003) enrolled in a case-control study of hormonal contraceptives and cervical cancer were tested for 27 cervical HPV types by reverse line blot analysis. Seroprevalence of HPV-16 IgG and IgA antibodies was assessed by virus-like particle-based enzyme-linked immunoassay in 908 and 904 control women, respectively, and 474 women with cervical cancer.

Cervical HPV prevalence was 26.1%. The HPV-16 IgG seroprevalence was 44.4% and IgA 28.7% in control women and significantly higher (61.8% and 52.7%, respectively) in women with cervical cancer (OR 2.1 and OR 2.8, respectively). Cervical HPV prevalence showed association with cervical disease and with HPV-16 IgG decreased while HPV-16 IgA increased with the increasing age (P trend <0.05). Oncogenic HPV type prevalence (including HPV-16) decreased with age whereas non-oncogenic HPV types showed limited association with age. Multivariate analysis revealed cervical HPV infection to be associated with HSV-2 infection (OR 1.7) and increasing years of education (OR 1.9). HPV-16 IgG antibodies were inversely associated with current smoking (OR 0.6) and HPV-16 IgA antibodies with the use of alcohol (OR 2.1) and inversely associated with the use of oral contraceptives (OR 0.6).

High exposure to HPV and particularly HPV-16 was evident in this population. The apparent increase of serum HPV-16 IgA with increasing age requires further investigation.