Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique

Abstract Background Limited data are available about the distribution of human papillomavirus (HPV) among women undergoing cervical cancer screening in Mozambique. We describe the prevalence of high-risk HPV risk groups detected in women who participated in the MULHER Study, a prospective trial of M...

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Main Authors: Cristina Mendes de Oliveira, Ricardina Rangeiro, Nafissa Osman, Ellen Baker, Andrea Neves, Arlete A. N. Mariano, Guilhermina Tivir, Joseph P. Thomas, Jennifer Carns, Viviane Andrade, Carla Carrilho, Eliane C. S. Monteiro, Hannah Hoover, Edson Chivambo, Marcos Chissano, Elizabeth Chiao, Hira Atif, Philip E. Castle, Rebecca Richards-Kortum, Eva Lathrop, Kathleen M. Schmeler, Cesaltina Lorenzoni, Mila P. Salcedo
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Infectious Agents and Cancer
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Online Access:https://doi.org/10.1186/s13027-025-00655-1
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author Cristina Mendes de Oliveira
Ricardina Rangeiro
Nafissa Osman
Ellen Baker
Andrea Neves
Arlete A. N. Mariano
Guilhermina Tivir
Joseph P. Thomas
Jennifer Carns
Viviane Andrade
Carla Carrilho
Eliane C. S. Monteiro
Hannah Hoover
Edson Chivambo
Marcos Chissano
Elizabeth Chiao
Hira Atif
Philip E. Castle
Rebecca Richards-Kortum
Eva Lathrop
Kathleen M. Schmeler
Cesaltina Lorenzoni
Mila P. Salcedo
author_facet Cristina Mendes de Oliveira
Ricardina Rangeiro
Nafissa Osman
Ellen Baker
Andrea Neves
Arlete A. N. Mariano
Guilhermina Tivir
Joseph P. Thomas
Jennifer Carns
Viviane Andrade
Carla Carrilho
Eliane C. S. Monteiro
Hannah Hoover
Edson Chivambo
Marcos Chissano
Elizabeth Chiao
Hira Atif
Philip E. Castle
Rebecca Richards-Kortum
Eva Lathrop
Kathleen M. Schmeler
Cesaltina Lorenzoni
Mila P. Salcedo
author_sort Cristina Mendes de Oliveira
collection DOAJ
description Abstract Background Limited data are available about the distribution of human papillomavirus (HPV) among women undergoing cervical cancer screening in Mozambique. We describe the prevalence of high-risk HPV risk groups detected in women who participated in the MULHER Study, a prospective trial of Mozambican women undergoing cervical cancer screening with HPV testing. Methods From January 2020 to January 2023, 9,014 women aged 30–49 years in Maputo City and Gaza Province, Mozambique underwent cervical cancer screening. Cervicovaginal samples were self-collected (97.5%) or provider-collected (2.5%) and primary HPV testing was performed using the GeneXpert HPV testing platform (Cepheid Inc, USA) which provided data on HR-HPV risk groups: HPV16, HPV18/45 and 11 other HR-HPV types in aggregate. Women with a positive HR-HPV test underwent visual assessment using dilute acetic acid applied to the cervix for treatment decisions. Results Of the 9,014 women enrolled in the MULHER Study, 8,954 (99.3%) had a valid HPV test result. Of those, 2,805 (31.3%) tested positive for at least one HR-HPV group: HPV16 (n = 475, 16.9%), HPV18/45 (n = 686, 24.6%) and other HR-HPV (n = 2,150, 77.1%). A total of 17.8% were positive for multiple HPV HR groups. HR-HPV infection prevalence was higher among women living with HIV (WLWH) than HIV-negative women (39.7% vs. 24.3% respectively; p < 0.001). WLWH were more likely to test positive for HPV18/45 (p = 0.03) and for two or more HR-HPV risk groups (P < 0.0001) compared with HIV-negative women. HPV16 was the most frequently detected HR-HPV group (56.7%) among women diagnosed with invasive cervical cancer. Conclusions HR-HPV prevalence was high among Mozambican women aged 30–49 years, especially among WLWH, consistent with the high burden of cervical cancer in this population. HPV16 was the most common HR-HPV group among women with cervical cancer. Further study is needed to determine the role of HR-HPV genotyping in follow-up and treatment in Mozambique.
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spelling doaj-art-82b615dd5bd548fa8a9162b415a4c8a42025-08-20T02:19:57ZengBMCInfectious Agents and Cancer1750-93782025-04-012011710.1186/s13027-025-00655-1Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in MozambiqueCristina Mendes de Oliveira0Ricardina Rangeiro1Nafissa Osman2Ellen Baker3Andrea Neves4Arlete A. N. Mariano5Guilhermina Tivir6Joseph P. Thomas7Jennifer Carns8Viviane Andrade9Carla Carrilho10Eliane C. S. Monteiro11Hannah Hoover12Edson Chivambo13Marcos Chissano14Elizabeth Chiao15Hira Atif16Philip E. Castle17Rebecca Richards-Kortum18Eva Lathrop19Kathleen M. Schmeler20Cesaltina Lorenzoni21Mila P. Salcedo22DasaHospital Central de MaputoHospital Central de MaputoDepartment of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer CenterHospital Geral e Centro de Saúde José MacamoHospital Geral e Centro de Saúde de MavalanePopulation Services InternationalDepartment of Oncology Care & Research, The University of Texas MD Anderson CancerRice UniversityICON plcHospital Central de MaputoHospital Geral e Centro de Saúde de MavalanePopulation Services InternationalPopulation Services InternationalPopulation Services InternationalDepartment of Epidemiology, The University of Texas MD Anderson Cancer CenterUniversidade Eduardo Mondlane (UEM)National Cancer InstituteRice UniversityPopulation Services InternationalDepartment of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer CenterHospital Central de MaputoDepartment of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer CenterAbstract Background Limited data are available about the distribution of human papillomavirus (HPV) among women undergoing cervical cancer screening in Mozambique. We describe the prevalence of high-risk HPV risk groups detected in women who participated in the MULHER Study, a prospective trial of Mozambican women undergoing cervical cancer screening with HPV testing. Methods From January 2020 to January 2023, 9,014 women aged 30–49 years in Maputo City and Gaza Province, Mozambique underwent cervical cancer screening. Cervicovaginal samples were self-collected (97.5%) or provider-collected (2.5%) and primary HPV testing was performed using the GeneXpert HPV testing platform (Cepheid Inc, USA) which provided data on HR-HPV risk groups: HPV16, HPV18/45 and 11 other HR-HPV types in aggregate. Women with a positive HR-HPV test underwent visual assessment using dilute acetic acid applied to the cervix for treatment decisions. Results Of the 9,014 women enrolled in the MULHER Study, 8,954 (99.3%) had a valid HPV test result. Of those, 2,805 (31.3%) tested positive for at least one HR-HPV group: HPV16 (n = 475, 16.9%), HPV18/45 (n = 686, 24.6%) and other HR-HPV (n = 2,150, 77.1%). A total of 17.8% were positive for multiple HPV HR groups. HR-HPV infection prevalence was higher among women living with HIV (WLWH) than HIV-negative women (39.7% vs. 24.3% respectively; p < 0.001). WLWH were more likely to test positive for HPV18/45 (p = 0.03) and for two or more HR-HPV risk groups (P < 0.0001) compared with HIV-negative women. HPV16 was the most frequently detected HR-HPV group (56.7%) among women diagnosed with invasive cervical cancer. Conclusions HR-HPV prevalence was high among Mozambican women aged 30–49 years, especially among WLWH, consistent with the high burden of cervical cancer in this population. HPV16 was the most common HR-HPV group among women with cervical cancer. Further study is needed to determine the role of HR-HPV genotyping in follow-up and treatment in Mozambique.https://doi.org/10.1186/s13027-025-00655-1HPVCervical cancerScreening
spellingShingle Cristina Mendes de Oliveira
Ricardina Rangeiro
Nafissa Osman
Ellen Baker
Andrea Neves
Arlete A. N. Mariano
Guilhermina Tivir
Joseph P. Thomas
Jennifer Carns
Viviane Andrade
Carla Carrilho
Eliane C. S. Monteiro
Hannah Hoover
Edson Chivambo
Marcos Chissano
Elizabeth Chiao
Hira Atif
Philip E. Castle
Rebecca Richards-Kortum
Eva Lathrop
Kathleen M. Schmeler
Cesaltina Lorenzoni
Mila P. Salcedo
Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique
Infectious Agents and Cancer
HPV
Cervical cancer
Screening
title Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique
title_full Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique
title_fullStr Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique
title_full_unstemmed Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique
title_short Evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in Mozambique
title_sort evaluation of hpv risk groups among women enrolled in the mulher cervical cancer screening study in mozambique
topic HPV
Cervical cancer
Screening
url https://doi.org/10.1186/s13027-025-00655-1
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