Incidence, Persistence, and Determinants of Human Papillomavirus: A Prospective Cohort Study of HIV-Negative Nigerian Women

63 Background: Cervical cancer is the second most common cancer in Africa. Persistent high-risk human papillomavirus (HRHPV) infection is a necessary cause but little is known about the persistence and associated risk factors of HRHPV infection in African women. We undertook this work to determine risk factors and the incidence of HPV infection in Nigerian women. Methods: ACCME is a multicenter, prospective cohort study of host germline, cervical somatic and HRHPV genomics, epigenomics, and vaginal microenvironment and their association with HPV. From February 2014 to January 2016, 10,000 HIV-negative women were enrolled in the cohort and are being observed every 6 months. We used SPF25/LiPA10 to characterize HPV infection and defined persistent infection as two consecutive positive tests performed at least 12 months apart. Logistic regression models were used to estimate associations between risk factors and persistent HPV. Results: The mean (± standard deviation) age of study participants at baseline was 40 (± 10) years, and mean (± standard deviation) vaginal pH was 5.2 (± 0.6). Approximately 42% of participants were positive for any HPV and 21% had persistence of any HPV infection. Some (35%) participants had multiple infections with any HPV. Approximately 54% of those with persistent any HPV infection had HRHPV—HPV type 52 (25%) and type 18 (15%) were the most prevalent and persistent HRHPV types. Incidence of any HPV infection was 6.6 per 1,000 person-months, whereas that of HRHPV was 2.6 per 1,000 person-months. Age, body mass index, education level, marital and socioeconomic status, and total number of lifetime sexual partners were associated with HPV infection in these women. Conclusion: We defined the incidence, risk factors, and most common types of HRHPV in a large cohort of women in West Africa. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Sally N. Adebamowo No relationship to disclose Michael Odutola No relationship to disclose Ayotunde Famooto No relationship to disclose Eileen Dareng No relationship to disclose Amos Adebayo No relationship to disclose Peter Achara No relationship to disclose Bunmi Alabi No relationship to disclose Kayode Obende No relationship to disclose Richard Offiong No relationship to disclose Sanni Ologun No relationship to disclose Clement A. Adebamowo Speakers' Bureau: Merck