Prevalence of Human Papillomavirus in Different Mucous Membranes in HIV Concordant Couples in Rwanda

Background: The prevalence of human papillomavirus (HPV) infections in other anatomical sites besides the uterine cervix is unknown in East Africa. Here, we assessed the prevalence and concordance of HPVs in different anatomical sites in HIV concordant couples in Rwanda. Methods: Fifty HIV-positive concordant male-female couples at the HIV clinic at the University Teaching Hospital of Kigali in Rwanda were interviewed, swabbed from the oral cavity (OC), oropharynx (OP), anal canal (AC), vagina (V), uterine cervix (UC) and penis. A pap smear test and a self-collected vaginal swab (Vself) were taken. Twelve high-risk (HR)-HPVs were analyzed. Results: HR-HPVs occurred in 10%/12% in OC, 10%/0% in OP and 2%/24% in AC (p = 0.002) in men and women, respectively. HR-HPVs occurred in 24% of UC, 32% of Vself, 30% of V and 24% of P samples. Only 22.2% of all HR-HPV infections were shared by both partners (kappa -0.34 +/- 0.11; p = 0.004). The type-specific HR-HPV concordance was significant between male to female OC-OC (kappa 0.56 +/- 0.17), V-VSelf (kappa 0.70 +/- 0.10), UC-V (kappa 0.54 +/- 0.13), UC-Vself (kappa 0.51 +/- 0.13) and UC-female AC (kappa 0.42 +/- 0.15). Conclusions: HPV infections are prevalent in HIV-positive couples in Rwanda but concordance within couples is low. Vaginal self-sampling for HPV is representative of cervical HPV status.

Automated summary

HPV infections are prevalent in HIV-positive couples in Rwanda, but concordance within couples is low. Vaginal self-sampling can represent cervical HPV status.