Human Papillomavirus Genotypes Distribution in High-Grade Cervical Lesions and Invasive Cervical Carcinoma in Women Living in Mauritania: Implications for Cervical Cancer Prevention and HPV Prophylactic Vaccination
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Collection of Biopsy Samples and Processing
2.3. DNA Extraction
2.4. HPV Detection and Genotyping by Multiplex PCR
2.5. Statistical Analysis
3. Results
3.1. Study Population
3.2. Overall Prevalence of HPV and HPV Genotypes Distribution
3.3. Possible Efficiencies of Cervical HPV Prevention by Gardasil® Vaccines
3.4. Determinants of HPV Outcomes and High-Grade Cervical Lesions and Invasive Carcinoma Using Logistic Regression Analyses
3.4.1. Simple Logistic Regression Analysis
3.4.2. Multivariate Logistic Regression Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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All Women (n = 50) | CIN2/3 (n = 14) | ADC (n = 4) | SCC (n = 32) | |
---|---|---|---|---|
Characteristics [n (%) [95% CI] *] | ||||
Age (Years) | ||||
All ages [Mean (SD)] | 56.7 (9.4) | 51.6 (10.3) | 58.5 (9.5) | 58.9 (8.3) |
30–39 | 3(6.0) [0.0–12.6] | 2(14.3) [0.0–32.6] | 0 (0.0) NA | 1 (3.1) [0.0–9.1] |
40–49 | 9 (18.0) [7.3–28.6] | 4 (28.6) [4.9–52.2] | 1 (25.0) [0.0–67.4] | 4 (12.5) [1.0–23.9] |
50–59 | 13 (26.0) [13.8–38.1] | 5 (35.7) [10.6–60.8] | 0 (0.0) NA | 8 (25.0) [10.0–40.0] |
60–69 | 20 (40.0) [26.4–53.3] | 2 (14.3) [0.0–32.6] | 3 (75.0) [32.6–100.0] | 15 (46.9) [29.6–64.2] |
≥70 | 5 (10.0) [1.7–18.3] | 1 (7.2) [0.0–20.6] | 0 (0.0) NA | 4 (12.5) [1.0–23.9] |
Marital status [n (%) CI] | ||||
Living in couple or married | 40 (80.0) [68.9–91.1] | 13 (92.8) [79.4–100.0] | 2 (50.0) [1.0–99.0] | 25 (78.1) [63.8–92.4] |
Divorced/widow | 10 (20.0) [8.9–31.1] | 1 (7.2) [0.0–20.6] | 2 (50.0) [1.0–99.0] | 7 (21.9) [7.5–36.2] |
Education level [n (%) CI] | ||||
Never schooled | 24 (48.0) [34.1–61.8] | 5 (35.7) [10.6–60.8] | 1 (25.0) [0.0–67.4] | 18 (56.2) [39.0–73.4] |
Elementary | 15 (30.0) [17.3–42.7] | 2 (14.3) [0.0–32.6] | 3 (75.0) [32.6–100.0] | 10 (31.2) [15.2–47.3] |
High school | 8 (16.0) [5.8–26.2] | 5 (35.7) [10.6–60.8] | 0 (0.0) NA | 3 (9.4) [0.0–19.5] |
University | 3 (6.0) [0.0–12.6] | 2 (14.3) [0.0–32.6] | 0 (0.0) NA | 1 (3.1) [0.0–9.1] |
Gravidity [n (%) CI] | ||||
1–3 | 6 (12.0) [2.9–21.0] | 4 (28.6) [4.9–52.2] | 0 (0.0) NA | 2 (6.2) [0.0–14.6] |
4–5 | 31 (62.0) [48.5–75.4] | 7 (50.0) [23.8–76.2] | 3 (75.0) [32.6–100.0] | 21 (65.6) [49.2–82.1] |
≥6 | 13 (26.0) [13.8–38.1] | 3 (21.4) [0.0–42.9] | 1 (25.0) [0.0–67.4] | 9 (28.2) [12.5–43.7] |
Parity [n (%) CI] | ||||
1–3 | 14 (28.0) [15.5–40.4] | 5 (35.7) [10.6–60.8] | 1 (25.0) [0.0–67.4] | 8 (25.0) [10.0–40.0] |
4–5 | 35 (70.0) [57.3–82.7] | 8 (57.1) [31.2–83.1] | 3 (75.0) [32.6–100.0] | 24 (75.0) [60.0–90.0] |
≥6 | 1 (2.0) [0.0–5.9] | 1 (7.2) [0.0–20.6] | 0 (0.0) NA | 0 (0.0) NA |
Menopause [n (%) CI] | ||||
Yes | 42 (84.0) [73.8–94.1] | 10 (71.4) [47.8–95.1] | 3 (75.0) [32.6–100.0] | 29 (90.6) [80.5–100.0] |
No | 8 (16.0) [5.8–26.1] | 4 (28.6) [4.9–52.2] | 1 (25.0) [0.0–67.4] | 3 (9.4) [0.0–19.5] |
FIGO Staging [n (%) CI] | ||||
[0] | 14 (28.0) [15.5–40.5] | 14 (100.0) NA | 0 (0.0) NA | 0 (0.0) NA |
IA/B | 14 (28.0) [15.5–40.5] | 0 (0.0) NA | 3 (75.5) [32.6–100.0] | 11 (34.4) [17.9–50.8] |
IIA/B | 12 (24.0) [12.1–35.8] | 0 (0.0) NA | 1 (25.0) [0.0–67.4] | 11 (34.4) [17.9–50.8] |
IIIA/B | 8 (16.0) [5.8–26.1] | 0 (0.0) NA | 0 (0.0) NA | 8 (25.0) [10.0–40.0] |
IVA/B | 2 (4.0) [0.0–9.4] | 0 (0.0) NA | 0 (0.0) NA | 2 (6.2) [0.0–14.6] |
HPV DNA detection and genotypes [n (%) CI] | ||||
HPV DNA | 47 (94.0) [87.4–100.0] | 12 (85.7) [67.4–100.0] | 4 (100.0) NA | 31 (96.9) [90.8–100.0] |
Multiple types of any HPV | 27 (54.0) [53.4–67.7] | 7 (50.0) [23.8–76.2] | 2 (50.0) [1.0–99.0] | 18 (56.2) [39.0–73.4] |
LR-HPV | 5 (10.0) [1.7–18.3] | 2 (14.3) [0.0–32.6] | 0 (0.0) NA | 3 (9.4) [0.0–19.5] |
HR-HPV | 47 (94.0) [87.4–100.0] | 12 (85.7) [67.4–100.0] | 4 (100.0) NA | 31 (96.9) [90.8–100.0] |
Multiple types of HR-HPV | 24 (48.0) [34.1–61.8] | 5 (35.7) [10.6–60.8] | 2 (50.0) [1.0–99.0] | 17 (53.1) [35.8–70.4] |
Possibly oncogenic HPV | 3 (6.0) [0.0–12.6] | 0 (0.0) NA | 0 (0.0) NA | 3 (9.4) [0.0–19.5] |
HPV-16 | 18 (36.0) [22.7–49.3] | 4 (28.6) [4.9–52.2] | 3 (75.0) [32.6–100.0] | 11 (34.4) [17.9–50.8] |
HPV-18 | 7 (14.0) [4.4–23.6] | 1 (7.1) [0.0–20.6] | 1 (25.0) [0.0–67.4] | 5 (15.6) [3.0–28.2] |
Any 4-valent vaccine types ** | 24 (48.0) [34.1–61.8] | 5 (35.7) [10.6–60.8] | 3 (75.0) [32.6–100.0] | 16 (50.0) [32.7–67.3] |
Multiple 4-valent vaccine types | 0 (0.0) NA | 0 (0.0) NA | 0 (0.0) NA | 0 (0.0) NA |
Any 9-valent vaccine types *** | 44 (88.0) [78.9–97.0] | 11 (78.6) [57.1–100.0] | 4 (100.0) NA | 29 (90.6) [80.5–100.0] |
Multiple 9-valent vaccine types | 18 (36.0) [22.7–49.3] | 4 (28.6) [4.9–52.2] | 1 (25.0) [1.0–99.0] | 9 (28.1) [20.7–54.3] |
Nonvaccine HR-HPV types | 14 (28.0) [15.5–40.4] | 3 (35.7) [0.0–48.1] | 2 (50.0) [0.0–67.4] | 10 (31.2) [15.2–48.9] |
HPV | Multiple HPV | HR-HPV | Multiple HR-HPV | & Gardasil® HR-HPV | £ Gardasil-9® HR-HPV | Multiple Gardasil-9® HR-HPV | Nonvaccine HR-HPV | Possibly Oncogenic HPV | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
cOR (95% CI) | p a | cOR (95% CI) | p | cOR (95% CI) | p | cOR (95% CI) | p | cOR (95% CI) | p | cOR (95% CI) | p | cOR (95% CI) | p | cOR (95% CI) | p | cOR (95% CI) | p | |
Age | ||||||||||||||||||
30–39 | NC b | NC | 1.76 (0.16–39.38) | 0.645 | NC | NC | 2.273 (0.21–50.86) | 0.501 | 2.087 (0.18–46.69) | 0.547 | 0.238 (0.02–5.65) | 0.313 | 0.882 (0.04–9.87) | 0.920 | 5.833 (0.52–132.3) | 0.149 | 4.2 (0.17–52.59) | 0.313 |
40–49 | 0.411 (0.03–9.44) | 0.509 | 0.354 (0.06–1.54) | 0.168 | 0.411 (0.03–9.44) | 0.509 | 0.476 (0.09–2.06) | 0.326 | 0.432 (0.08–1.87) | 0.265 | 1.111 (0.15–22.81) | 0.927 | 0.446 (0.06–20.13) | 0.327 | 0.691 (0.09–3.37) | 0.664 | 2.643 (0.32–16.61) | 0.332 |
50–59 | 0.685 (0.06–15.52) | 0.771 | 0.426 (0.11–1.53) | 0.191 | 0.685 (0.06–15.52) | 0.770 | 0.377 (0.08–1.38) | 0.143 | 0.812 (0.22–2.90) | 0.747 | 1.875 (0.26–37.85) | 0.562 | 0.44 (0.08–1.72) | 0.247 | 1.2 (0.27–4.65) | 0.797 | 0.533 (0.03–3.77) | 0.563 |
60–69 | NC | NC | 20.122 (0.67–7.08) | 0.200 | NC | NC | 3.208 (1.01–10.95) | 0.048 | 2.786 (0.88–9.41) | 0.081 | 1.385 (0.24–10.76) | 0.719 | 4.016 (1.22–14.30) | 0.022 | 0.777 (0.21–2.74) | 0.698 | 0.722 (0.09–40.12) | 0.719 |
≥70 | 0.186 (0.02–4.51) | 0.249 | 3.826 (0.52–77.97) | 0.201 | 0.186 (0.02–4.51) | 0.249 | 0.697 (0.08–4.59) | 0.704 | 0.218 (0.01–1.62) | 0.144 | 0.5 (0.57–10.80) | 0.587 | 0.412 (0.02–3.07) | 0.412 | 0.615 (0.03–4.67) | 0.665 | NC | NC |
Education level | ||||||||||||||||||
Never | 0.44 (0.02–4.89) | 0.502 | 2.727 (0.88–8.95) | 0.082 | 0.44 (0.02–4.89) | 0.501 | 1.612 (0.53–5.03) | 0.401 | 1.00 (0.33–3.05) | >0.99 | 0.913 (0.15–5.41) | 0.916 | 1.607 (0.51–5.26) | 0.422 | 0.75 (0.21–2.59) | 0.649 | NC | NC |
Elementary | 0.848 (0.07–19.12) | 0.897 | 0.444 (0.12–1.51) | 0.193 | 0.848 (0.07–19.12) | 0.897 | 0.629 (0.17–2.12) | 0.457 | 1.21 (0.36–4.16) | 0.757 | 0.838 (0.14–6.58) | 0.850 | 0.846 (0.22–2.95) | 0.796 | 0.545 (0.11–2.15) | 0.399 | 2.667 (0.44–16.24) | 0.272 |
High school | NC | NC | 0.826 (0.17–3.92) | 0.804 | NC | NC | 1.1 (0.23–5.22) | 0.901 | 0.545 (0.10–2.51) | 0.438 | 0.945 (0.12–19.56) | 0.962 | 1.08 (0.19–5.04) | 0.923 | 3.2 (0.65–15.96) | 0.147 | 7.8 (1.18–54.18) | 0.034 |
University | NC | NC | 0.403 (0.02–4.49) | 0.457 | NC | NC | 0.522 (0.02–5.81) | 0.596 | 2.087 (0.18–46.69) | 0.547 | NC | NC | NC | NC | 1.308 (0.05–14.81) | 0.834 | NC | NC |
Marital status | ||||||||||||||||||
Living in couple | NC | NC | 0.226 (0.03–1.04) | 0.056 | NC | NC | 0.316 (0.06–1.32) | 0.116 | 0.351 (0.06–1.46) | 0.152 | NC | NC | 0.807 (0.19–3.61) | 0.769 | 0.885 (0.20–4.66) | 0.875 | 1.286 (0.17–26.24) | 0.824 |
Divorced/ Widowed | NC | NC | 4.421 (0.96–31.78) | 0.056 | NC | NC | 3.157 (0.75–16.34) | 0.116 | 2.852 (0.68–14.74) | 0.152 | NC | NC | 1.238 (0.27–5.09) | 0.769 | 1.13 (0.22–4.91) | 0.875 | 0.777 (0.04–5.68) | 0.824 |
Gravidity | ||||||||||||||||||
1–3 | NC | NC | 0.833 (0.14–4.94) | 0.834 | NC | NC | 1.095 (0.18–6.49) | 0.916 | 0.456 (0.06–2.59) | 0.380 | 0.641 (0.07–13.57) | 0.719 | 0.875 (0.11–5.02) | 0.884 | 1.333 (0.17–7.81) | 0.76 | 5.00 (0.57–36.24) | 0.134 |
4–5 | 0.805 (0.03–9.01) | 0.862 | 1.093 (0.34–3.46) | 0.879 | 0.805 (0.04–9.01) | 0.862 | 1.467 (0.46–4.75) | 0.513 | 1.67 (0.53–5.43) | 0.381 | 0.794 (0.10–4.54) | 0.800 | 1.368 (0.42–4.79) | 0.608 | 2.933 (0.76–14.61) | 0.122 | 1.259 (0.22–9.79) | 0.801 |
≥6 | 0.685 (0.06–15.52) | 0.771 | 0.992 (0.27–3.63) | 0.989 | 0.685 (0.06–15.52) | 0.770 | 0.592 (0.15–2.12) | 0.422 | 0.812 (0.22–2.90) | 0.747 | 1.875 (0.26–37.85) | 0.562 | 0.731 (0.17–2.72) | 0.645 | 0.154 (0.01–0.92) | 0.038 | NC | NC |
Parity | ||||||||||||||||||
≥2 | 0.088 (0.01–2.36) | 0.126 | NC | NC | 0.088 (0.01–2.36) | 0.126 | NC | NC | NC | NC | 0.238 (0.02–5.65) | 0.313 | NC | NC | NC | NC | NC | NC |
3–4 | 2.947 (0.26–66.05) | 0.374 | 2.182 (0.70–7.05) | 0.177 | 2.947 (0.26–66.05) | 0.374 | 4.091 (1.26–14.55) | 0.017 | 1.179 (0.38–3.67) | 0.774 | 1.444 (0.24–8.59) | 0.673 | 3.967 (1.14–16.45) | 0.029 | 2.237 (0.62–9.38) | 0.223 | 4.167 (0.61–83.29) | 0.158 |
≥5 | 1.133 (0.10–25.43) | 0.921 | 0.777 (0.24–2.49) | 0.670 | 1.133 (0.11–25.43) | 0.921 | 0.388 (0.11–1.26) | 0.116 | 1.417 (0.44–4.62) | 0.555 | 1.143 (0.19–8.91) | 0.884 | 0.367 (0.08–1.28) | 0.120 | 0.628 (0.15–2.29) | 0.490 | 0.317 (0.02–2.19) | 0.267 |
Menopause | NC | NC | 1.211 (0.25–5.75) | 0.804 | NC | NC | 0.909 (0.19–4.31) | 0.902 | 1.00 (0.21–4.74) | >0.99 | 1.057 (0.05–8.03) | 0.962 | 0.926 (0.19–5.02) | 0.923 | 0.592 (0.12–3.26) | 0.523 | 0.315 (0.05–2.63) | 0.258 |
Clinical symptoms | ||||||||||||||||||
Metrorrhagia | NC | NC | 5.474 (0.74–111.7) | 0.100 | NC | NC | 4.182 (0.56–85.22) | 0.172 | 1.568 (0.24–12.77) | 0.636 | NC | NC | NC | NC | 0.545 (0.08–4.52) | 0.541 | NC | NC |
Pelvic pain | NC | NC | NC | NC | NC | NC | NC | NC | 0.479 (0.02–5.33) | 0.547 | NC | NC | NC | NC | NC | NC | NC | NC |
Tumor | NC | NC | 0.846 (0.03–22.22) | 0.907 | NC | NC | 1.087 (0.04–28.54) | 0.954 | 1.00 (0.04–26.25) | >0.99 | NC | NC | NC | NC | NC | NC | NC | NC |
FIGO Staging | ||||||||||||||||||
0 | 0.172 (0.01–1.94) | 0.149 | 0.8 (0.23–2.79) | 0.723 | 0.172 (0.01–1.94) | 0.149 | 0.497 (0.13–1.73) | 0.275 | 0.444 (0.12–1.55) | 0.205 | 0.333 (0.05–2.03) | 0.222 | 0.628 (0.15–2.29) | 0.490 | 0.6198 (0.12–2.47) | 0.512 | 1.333 (0.17–7.81) | 0.76 |
IA/B | 0.764 (0.06–17.26) | 0.834 | 0.136 (0.03–0.53) | 0.003 | 0.764 (0.06–17.26) | 0.834 | 0.195 (0.04–0.75) | 0.016 | 0.671 (0.18–2.32) | 0.528 | 0.75 (0.128–5.912) | 0.760 | 0.208 (0.03–0.91) | 0.036 | 0.619 (0.12–2.47) | 0.512 | NC | NC |
IIA/B | NC | NC | 2 (0.53–8.55) | 0.308 | NC | NC | 1.729 (0.46–6.78) | 0.412 | 1.00 (0.26–3.74) | >0.99 | 1.667 (0.23–33.75) | 0.642 | 0.857 (0.19–3.26) | 0.824 | 1.4 (0.32–5.55) | 0.641 | 1.7 (0.21–10.14) | 0.581 |
IIIA/B | NC | NC | NC | NC | NC | NC | NC | 9.333 (1.47–182.6) | 0.015 | NC | NC | NC | NC | 0.833 (0.11–4.23) | 0.835 | 3.167 (0.38–20.51) | 0.258 | |
IVA/B | NC | NC | 0.846 (0.032–22.22) | 0.907 | NC | NC | 1.087 (0.04–28.54) | 0.954 | 1.00 (0.04–26.25) | >0.99 | NC | NC | NC | NC | NC | NC | NC | NC |
Previous HPV screening | NC | NC | 1.08 (0.25–4.92) | 0.917 | NC | NC | 1.447 (0.34–6.59) | 0.616 | 0.762 (0.16–3.27) | 0.712 | 1.111 (0.15–22.81) | 0.927 | 0.866 (0.16–3.81) | 0.853 | 2.48 (0.53–11.26) | 0.241 | 6.333 (0.98–42.27) | 0.052 |
Multiple HPV | Multiple HR-HPV | & Gardasil®-HR-HPV | Multiple £ Gardasil-9®HR-HPV | Nonvaccine HR-HPV | Possibly Oncogenic HPV | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
aOR (95% CI) | p a | aOR (95% CI) | p | aOR (95% CI) | p | aOR (95% CI) | p | aOR (95% CI) | p | aOR (95% CI) | p | |
Age (years) | ||||||||||||
30–39 | NA b | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
40–49 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
50–59 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
60–69 | NA | NA | 2.83 (0.74–10.82) | 0.127 | NA | NA | 4.25 (1.17–15.42) | 0.028 | NA | NA | NA | NA |
≥70 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Education level | ||||||||||||
Never | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Elementary | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
High school | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | 7.8 (1.22–49.67) | 0.03 |
University | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Marital status | ||||||||||||
Living in couple | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Divorced/Widowed | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Gravidity | ||||||||||||
1–3 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
4–5 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
≥6 | NA | NA | NA | NA | NA | NA | NA | NA | 0.15 (0.18–1.32) | 0.088 | NA | NA |
Parity | ||||||||||||
≥2 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
3–4 | NA | NA | 4.22 (1.10–16.10) | 0.035 | NA | NA | NA | NA | NA | NA | NA | NA |
≥5 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Menopause | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Clinical symptoms | ||||||||||||
Metrorrhagia | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Pelvic pain | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Tumor | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
FIGO Staging | ||||||||||||
0 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
IA/B | 0.136 (0.03–0.58) | 0.007 | 0.16 (0.03–0.77) | 0.022 | NA | NA | 0.19 (0.04–1.07) | 0.06 | NA | NA | NA | NA |
IIA/B | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
IIIA/B | NA | NA | NA | NA | 9.33 (1.05–82.78) | 0.045 | NA | NA | NA | NA | NA | NA |
IVA/B | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
Previous HPV screening | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
CIN2/3 | SCC | ADC | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
cOR (95% CI) | p a | aOR (95% CI) | p | cOR (95% CI) | p | aOR (95% CI) | p | cOR (95% CI) | p | aOR (95% CI) | p | |
Age (years) | ||||||||||||
30–39 | 5.88 (0.52–132.3) | 0.149 | NA c | NA | 0.26 (0.01–2.88) | 0.265 | NA | NA | NC b | NC | NA | NA |
40–49 | 2.48 (0.53–11.26) | 0.241 | NA | NA | 0.37 (0.08–1.62) | 0.185 | NA | NA | 1.58 (0.07–14.33) | 0.715 | NA | NA |
50–59 | 1.94 (0.48–7.48) | 0.338 | NA | NA | 0.86 (0.24–3.37) | 0.830 | NA | NA | NC | NC | NA | NA |
60–69 | 0.166 (0.03–0.72) | 0.015 | 0.32 (0.05–1.89) | 0.209 | 2.29 (0.68–8.55) | 0.181 | NA | NA | 5.12 (0.60–108.1) | 0.138 | NA | NA |
≥70 | 0.62 (0.03–4.67) | 0.665 | NA | NA | 2.43 (0.32–49.61) | 0.412 | NA | NA | NC | NC | NA | NA |
Education level | ||||||||||||
Never schooled | 0.49 (0.13–1.73) | 0.275 | NA | NA | 2.57 (0.79–9.03) | 0.116 | NA | NA | 0.33 (0.02–2.82) | 0.325 | NA | NA |
Elementary school | 0.29 (0.04–1.31) | 0.113 | NA | NA | 1.18 (0.34–4.49) | 0.796 | NA | NA | 8.5 (0.98–181.2) | 0.05 | NA | NA |
High school | 6.11 (1.26–34.78) | 0.024 | 1.63 (0.19–13.62) | 0.651 | 0.27 (0.04–1.26) | 0.095 | NA | NA | NC | NC | NA | NA |
University | 5.83 (0.52–132.3) | 0.149 | NA | NA | 0.26 (0.01–2.88) | 0.265 | NA | NA | NC | NC | NA | NA |
Marital status | ||||||||||||
Living in couple/married | 4.33 (0.70–84.22) | 0.125 | NA | NA | 0.71 (0.14–3.01) | 0.655 | NA | NA | 0.21 (0.02–1.96) | 0.158 | NA | NA |
Divorced/Widowed | 0.23 (0.02–1.42) | 0.125 | NA | NA | 1.4 (0.33–7.25) | 0.655 | NA | NA | 4.75 (0.51–44.78) | 0.158 | NA | NA |
Gravidity | ||||||||||||
1–3 | 6.8 (1.15–54.58) | 0.034 | 2.35 (0.28–19.08) | 0.425 | 0.23 (0.03–1.34) | 0.102 | NA | NA | NC | NC | NA | NA |
4–5 | 0.5 (0.14–1.77) | 0.279 | NA | NA | 1.52 (0.46–5.03) | 0.482 | NA | NA | 1.93 (0.22–40.66) | 0.565 | NA | NA |
≥6 | 0.71 (0.14–2.87) | 0.641 | NA | NA | 1.37 (0.36–5.82) | 0.645 | NA | NA | 0.94 (0.04–8.21) | 0.961 | NA | NA |
Parity | ||||||||||||
≥2 | 5.83 (0.52–132.3) | 0.149 | NA | NA | 0.25 (0.01–2.88) | 0.265 | NA | NA | NC | NC | NA | NA |
3–4 | 0.42 (0.12–1.47) | 0.177 | NA | NA | 2.38 (0.74–8.02) | 0.1459 | NA | NA | 0.71 (0.07–6.28) | 0.736 | NA | NA |
≥5 | 1.5 (0.41–5.34) | 0.532 | NA | NA | 0.56 (0.16–1.88) | 0.353 | NA | NA | 1.87 (0.2–16.85) | 0.551 | NA | NA |
Menopause | 0.31 (0.06–1.53) | 0.147 | NA | NA | 3.72 (0.79–20.42) | 0.095 | NA | NA | 0.54 (0.05–11.74) | 0.628 | NA | NA |
Clinical symptoms | ||||||||||||
Metrorrhagia | 0.22 (0.02–1.45) | 0.113 | NA | NA | 3 (0.45–24.68) | 0.249 | NA | NA | NC | NC | NA | NA |
Pelvic pain | NC | NC | NA | NA | NC | NC | NA | NA | NC | NC | NA | NA |
Tumor | NC | NC | NA | NA | NC | NC | NA | NA | NC | NC | NA | NA |
FIGO staging | ||||||||||||
0 | NC | NC | NA | NA | NC | NC | NA | NA | NC | NC | NA | NA |
IA/B | NC | NC | NA | NA | 2.62 (0.67–13.07) | 0.169 | NA | NA | 9.54 (1.09–204.2) | 0.041 | 9.54 (0.89–101.33) | 0.061 |
IIA/B | NC | NC | NA | NA | 8.91 (1.50–171.0) | 0.013 | 11.12 (1.12–109.99) | 0.039 | 1.10 (0.05–9.28) | 0.961 | NA | NA |
IIIA/B | NC | NC | NA | NA | NC | NC | NA | NA | NC | NC | NA | NA |
IVA/B | NC | NC | NA | NA | NC | NC | NA | NA | NC | NC | NA | NA |
Previous HPV screening | 8.25 (1.79–46.46) | 0.006 | 2.97 (0.36–24.32) | 0.31 | 0.21 (0.04–0.92) | 0.037 | 0.16 (0.03–0.94) | 0.043 | NC | NC | NA | NA |
HPV genotypes distribution profile | ||||||||||||
HPV | 0.17 (0.01–1.94) | 0.149 | NA | NA | 3.87 (0.34–87.11) | 0.265 | NA | NA | NC | NC | NA | NA |
Multiple HPV | 0.8 (0.23–2.79) | 0.724 | NA | NA | 0.91 (0.27–2.89) | 0.868 | NA | NA | 2.75 (0.32–57.87) | 0.367 | NA | NA |
HR-HPV | 0.17 (0.01–1.94) | 0.149 | NA | NA | 3.87 (0.34–87.11) | 0.265 | NA | NA | NC | NC | NA | NA |
Multiple HR-HPV | 0.49 (0.13–1.73) | 0.275 | NA | NA | 1.25 (0.39–4.07) | 0.705 | NA | NA | 3.57 (0.42–75.19) | 0.251 | NA | NA |
Possibly oncogenic HPV | 1.33 (0.17–7.81) | 0.76 | NA | NA | 1.143 (0.19–8.91) | 0.884 | NA | NA | NC | NC | NA | NA |
& Gardasil® HR-HPV | 0.44 (0.12–1.55) | 0.205 | NA | NA | 1 (0.31–3.21) | >0.999 | NA | NA | NC | NC | NA | NA |
£ Gardasil-9® HR-HPV | 0.33 (0.05–2.03) | 0.222 | NA | NA | 1.93 (0.32–11.60) | 0.454 | NA | NA | NC | NC | NA | NA |
Multiple Gardasil-9® HR-HPV | 0.63 (0.15–2.29) | 0.490 | NA | NA | 1.2 (0.36–4.22) | 0.767 | NA | NA | 1.87 (0.21–16.85) | 0.550 | NA | NA |
Nonvaccine HR-HPV | 0.62 (0.12–2.47) | 0.511 | NA | NA | 1.59 (0.43–6.70) | 0.490 | NA | NA | 0.84 (0.04–7.31) | 0.888 | NA | NA |
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Abdoudaim, M.S.; Mohamed Abdellahi, M.V.; Mohamed Baba, N.D.; Mboumba Bouassa, R.-S.; Ahmed, M.L.C.B.; Bélec, L. Human Papillomavirus Genotypes Distribution in High-Grade Cervical Lesions and Invasive Cervical Carcinoma in Women Living in Mauritania: Implications for Cervical Cancer Prevention and HPV Prophylactic Vaccination. Diagnostics 2024, 14, 1986. https://doi.org/10.3390/diagnostics14171986
Abdoudaim MS, Mohamed Abdellahi MV, Mohamed Baba ND, Mboumba Bouassa R-S, Ahmed MLCB, Bélec L. Human Papillomavirus Genotypes Distribution in High-Grade Cervical Lesions and Invasive Cervical Carcinoma in Women Living in Mauritania: Implications for Cervical Cancer Prevention and HPV Prophylactic Vaccination. Diagnostics. 2024; 14(17):1986. https://doi.org/10.3390/diagnostics14171986
Chicago/Turabian StyleAbdoudaim, Mariem Salma, Mohamed Val Mohamed Abdellahi, Nacer Dine Mohamed Baba, Ralph-Sydney Mboumba Bouassa, Mohamed Lemine Cheikh Brahim Ahmed, and Laurent Bélec. 2024. "Human Papillomavirus Genotypes Distribution in High-Grade Cervical Lesions and Invasive Cervical Carcinoma in Women Living in Mauritania: Implications for Cervical Cancer Prevention and HPV Prophylactic Vaccination" Diagnostics 14, no. 17: 1986. https://doi.org/10.3390/diagnostics14171986