When it comes to the spread of HPV in African countries, Western science efforts aren’t enough. Why this situation is dangerous for everyone.
Centers for Disease Control statistics show that 79 million Americans have human papillomavirus (HPV). With 14 million new infections each year, 80 % of women will get at least one type of HPV at some point in their lifetime, according to the Office on Women’s Health in the U.S. Department of Health and Human Services. Several strains of HPV cause cervical cancer, which is the third most common cancer in women and the second most frequent cause of cancer-related death globally.
“There’s a high cervical cancer rate in Nigeria, and there’s not much research on HPV variants”, Dr. Ngozi Dom-Chima said. “Now that the world has become global, people are migrating and carrying diseases. The variants that are circulating in Nigeria, while they’re not really seen here in the U.S., they’ll eventually get here.”
Together, Dom-Chima and lead investigator Prof. Sam Biswas obtained 90 cervical samples and spent six months processing samples using next-generation DNA sequencing to identify multiple HPV types in samples. Type-specific PCR analysis was then used to verify the HPV types circulating in Nigeria. Their research found strikingly high rates of multiple HPV infections in most patients, with as many as nine HPV types identified in a single sample.
Their discovery of 25 prevalent strains of HPV in Nigeria underscores the need for more region-specific vaccines. The leading HPV vaccine, Gardasil-9, only protects against nine cancer-causing types of the virus that are prevalent in the U.S. Just six of the 25 types of HPV circulating in Nigeria are prevented by that vaccine. “While the vaccine is still very effective, it’s not enough for a country like Nigeria”, Biswas said. “We must come up with a vaccine that’s specific to the strains circulating in certain countries.”
“Pharmaceutical companies must realize there’s no one-size-fits-all approach when it comes to HPV vaccines”, Dom-Chima said. “They need to look at data from different countries and develop region-specific effective vaccines since the ones we have don’t cover most of the types of HPV that are prevalent in Nigeria right now.”
“Nigeria doesn’t have the money to provide vaccinations to all women”, Biswas said. “With advanced healthcare systems in the U.S. and Europe, we have a stronger ability to combat HPV, cervical cancer, and cancer deaths, but countries like Nigeria don’t have that ability. Even though we have many different types of HPV in the U.S., the death rate from cervical cancer is much lower. Infections and cancers that can be more readily treated in the U.S., could lead to someone dying every day in Nigeria.”
Access to vaccines in Nigeria is also limited. Globally, just one in eight girls is vaccinated against HPV, according to the United Nations Children’s Fund (UNICEF). UNICEF introduced the HPV vaccine to 52 countries, including seven countries, for the first time this year. Nigeria was one of those countries. Until region-specific vaccines are developed and access to those vaccines is expanded, HPV continues to silently spread and kill. In addition, populations of the world aren’t testing for the STI – another problem.
“Laboratory tests for HPV only test for a limited number of high- and low-risk variants”, said Prof. Esther Biswas-Fiss, co-investigator on the research. “Hybrid capture, a test commonly used in women’s healthcare, recognizes 13 HPV types. Like the vaccine, it’s designed to detect strains that are found to be prevalent in the U.S., but it won’t pick up some of the other strains that the sensitive methods used in the Biswas lab have identified.”
“In the U.S., many are unaware of the significance of the problem”, Biswas-Fiss said. “HPV is a slow-moving virus that doesn’t distinguish between men and women. Previous research tied tobacco and alcohol consumption to head and neck cancers, but now HPV is the leading cause of head and neck cancer in the U.S.”
“Scientists in Africa, Asia, and South America should do similar studies to identify which types of HPV are prevalent there to aid in region-specific vaccine development”, Biswas explained. “The United Nations could also step in and try to solve this problem.”
This article is based on a press release by the University of Delaware. You can find the original publication here.
Image source: Ovinuchi Ejiohuo, Unsplash
