Circulating High-risk HPV Genotypes in the South of Benin and Disparity with General Immunization Target

Background High-Risk Oncogenic Human Papillomaviruses (HR-HPV) are accountable for 7.7% of cancers in developing countries, mainly cervical lesions. In Benin, HR-HPV infection in women triggered nearly 781 new cases of cervical cancer each year leading to 616 (79%) deaths. Current vaccines may not cover all HR-HPV genotypes encountered in West Africa including Benin. The objective of our study was to determine HR-HPV genotypes in the South of Benin to launch regional HPV mapping associated to cervical lesions. For this purpose, HR-HPV genotypes from 2017 was compared to HPV genotypes from 2007 in the south of Benin to evaluate HR-HPV trend over a decade along with associated cervical lesions. Methods: regardless of technical methods, retrospective comparative analysis was done on HR-HPV genotypes of cervical uterine swab (CUS) samples in 2017 (n= 234) and 2007 (n=385). In 2017 real-time multiplexed PCR was used while in 2007-traditional nested polymerase chain reaction (PCR) was used. In both cases screening of cervical precancerous and cancerous lesions (dysplasia) was performed by colposcopy subsequently to vaginal application of acetic acid (VIA) and Lugol’s iodine solution (VILI). Statistical analysis was done with Pearson chi2 (χ2) test proportions and Student test. The difference was considered statistically significant for p <0.05. Results: The prevalence of HPV infected women in 2017 was 34% with 30 co-infections. Overall HR-HPV count was 125 with high frequency for HPV52 (16%), HPV58 (10%), HPV51 (9%), HPV66 (8%), HPV68 (8%), HPV35 (8%) and HPV45 (8%). The least frequent genotypes were HPV18 (6%), HPV16 (1.6%) and HPV33 (1.6%). Positive VIA and VILI were observed respectively in 5.55% (13/234) and 6.83% (16/234) women. In 2007 the prevalence of HR-HPV was 22.07% with 18 co-infections. Common HR-HPV genotypes found were HPV 35 (14.28%), HPV31 (13.33%), HPV66 (13.33%), HPV68 (13.33%), HPV58 (10.47%), HPV52 (8.57%), HPV51 (7.61%), HPV18 (6.66%), HPV45 (5.71%), HPV16 (3.80%) and HPV33 (3.80%). No correlation was observed between HR-HPV and cervical lesions. Conclusion: HR-HPV infection keep rising over a decade in the south of Benin with noticeable disparity with cervical lesions. Regional HR-HPV trend should be investigated prior to large scale vaccination for cervical cancer prevention in Africa