Project Title

The epidemiology of HPV infection and related disease among HIV infected men in South Africa (TEHSA)

EDCTP Project Call

Career Development Fellowship (CDF)

Project Objectives

Aim: generate further evidence regarding the epidemiology and burden of disease associated with HPV infection in HIV positive men, in order to inform future prevention policies in South Africa (SA). Specific Objectives: 1) Describe and report the epidemiology of anogenital and oropharyngeal cancer patterns and trends in men including incidence and mortality rates and differences by ethnicity in SA between 1994 and 2010. Furthermore, the influence of HIV status on epidemiology of these cancers will be explored. 2) Determine the prevalence of anogenital and oropharyngeal HPV infection, genotype distribution, and associations with anogenital disease, according to HIV-related factors (e.g. plasma viral load, CD4+ counts) and exposure to antiretroviral treatment (ART). a) Within this, compare the performance of oral swabs to oral rinses in detecting oral HPV infection in an urban cohort of HIV positive men in SA. 3) Determine the incidence, persistence, and clearance of type-specific anogenital and oropharyngeal HPV infection and anal cytological lesions over 18 months and the effects of HIV-related factors and ART on these outcomes. a) Within this, determine the clinical relevance of HPV viral load to predict persistence of infection and cytological abnormalities at follow-up and effects of HIV-related factors on these outcomes.

Study Design

Multi-design: (i) Review of the pathology based cancer reports from the South Africa National Cancer Registry (NCR) and mortality statistics from Statistics South Africa from 1994 to 2013 (ii) A 18 months observational cohort of 304 HIV-infected men from Johannesburg.

Host Organisation

Current Organisation

Wits Reproductive and HIV Research Institute, University of the Witwatersrand

Current Job Title

Senior Research Clinician

Biography