1. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Characterisation of Human Papillomavirus Genotypes: Preliminary report of the Nigerian Cervical pre- Cancer Surveillance Study Authors: Okwuraiwe AP 1, Ohihoin G 2 Audu RA 1, Achanya DA 1, Musa ZA 2, Ezechi OC 2, Ujah IAO 2 and the National HPV research group 1 Human Virology Laboratory and 2 Clinical Sciences Division of Nigerian Institute of Medical Research (NIMR) Yaba, Lagos, Nigeria. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ Nigerian Institute of Medical Research, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ Nigerian Institute of Medical Research, Yaba, Lagos.

2. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Background  Human papillomavirus (HPV) is the causative organism of cervical cancer and its precursor, cervical intraepithelial neoplasia (CIN)  Presence of HPV has been implicated in greater than 99% of cervical cancers, worldwide (Walboomers et al, 1999). Second most common cancer among women world over (Bosch et al, 2002).  An estimated prevalence of 11.7% globally, and 24% in Sub-Saharan Africa (WHO/ICO HPV information centre, 2010).  Globally five common types exist: HPV16 (3.2%), HPV18 (1.4%), HPV52 (0.9%), HPV31 (0.8%), and HPV58 (0.7%).  The Nigerian National Cervical Cancer Control Policy-2010 recommended vaccination of girls aged 9-15 years, with the HPV vaccine that prevents cervical cancer due to HPV genotypes 16 and 18.  Unfortunately this policy decision was not supported by in-country evidence, which has cast doubt on the effectiveness of the vaccine to prevent cervical cancer in Nigerian women.

3. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Study Objective  To characterise the circulating high risk cervical HPV genotypes among Nigerian women.

4. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Methods  Cervical specimens of 341 women attending clinics across the 6 geopolitical zones of Nigeria were collected by stirring into PCR cell collection media vigorously.  HPV genotype assay was performed with the COBAS 4800 System and reagents (Roche Diagnostics, Germany).  Test specifically identifies HPV16, HPV18 while concurrently detecting the twelve other high risk (OHR) genotypes together  Statistical analysis was done using Microsoft® Excel (mean±SD)

5. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Results 1  Participants’ age distribution was 18-59 years, with a mean age of 28.6±3.4 years. Majority (32.5%) were between 26 and 32 years.  Mean age at first sexual exposure was 20.4±3.9 years  Mean total life-time sexual partners was 3.2±2.1 (range: 1-8)  Other-high-risk (non HPV genotype 16 and 18) were the most common genotype (9.3%) detected; followed by HPV 18 (1.5%) and HPV 16 (0.9%).

6. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Results 2 Table 1: HPV prevalence by genotype from 341 women across 6 geo-political zones in Nigeria. HPV GenotypeFrequency (n)Percentage (%) 1630.9 1851.5 OHR32 9.4 12.4 16, 18 & OHR10.3 16 & OHR10.3 NEGATIVE26778.3 INVALIDS329.4 TOTAL341100

7. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Results 3 Table 1: Zonal Distribution of HPV genotypes in Nigeria. Zone HPV positive (n) Percentage (%) Nassarawa49.5 Ondo24.7 Kaduna24.7 Edo24.7 Plateau1023.8 Kwara614.3 Enugu716.7 Ebonyi37.1 Benue49.5 Lagos24.7 TOTAL42100

8. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Discussion  HPV has a high (12.4 %) prevalence among Nigerian women.  The other high risk genotypes are more prevalent (9.4%) than HPV 16 and 18, that are globally known to cause cervical cancer and are the targets for currently manufactured vaccines  A more specific assay is needed to decipher which of the 12 OHR HPV genotypes (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68) are to be found in Nigerian women.  The study is still on-going

9. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Conclusion  Other high risk genotypes were the most prevalent HPV genotypes detected.  HPV 16 and 18 may not be the major cause of cervical cancer in Nigerian women.  Further study to determine the specific genotype of the other high risk group is recommended.  A new policy on cervical cancer envisaged. NIMR 6 th Annual Scientific Conference 11TH-13TH Nov. 2014 @ Shehu Musa Yar’Adua Centre, Central Business District, Garki, Abuja. NIMR 6 th Annual Scientific Conference 11TH-13TH Nov. 2014 @ Shehu Musa Yar’Adua Centre, Central Business District, Garki, Abuja.

10. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. NIMR 6 th Annual Scientific Conference 10TH-12TH Nov. 2015 @ NIMR Auditorium, 6 Edmond Crescent, Yaba, Lagos. Thank you