Epidemiology of Human Papillomavirus and the Role of the Cytokines TNF-Alpha and IL-18 in Sexually Active Young Congolese Women

Abstract

Human papillomavirus (HPV) infection is a virosis that affects women with genotypes that can lead to cervical cancer under the impetus of certain external factors such as early sexual intercourse, prolonged use of oral contraceptives and expression of cytokines at high concentrations. This study, which took place in Pointe-Noire and Brazzaville, Republic of Congo, between 7 December 2019 and 20 September 2021, involved a population of 250 young women in schools and in medical consultations. The prevalence of HPV using the GèneXpert real-time PCR technique is estimated at 38%, with a predominance of genotype 16 (38.9%). Concentrations of the cytokines TNF α and IL18 were measured using the ELISA technique, giving concentrations of 266.2 ng/mL and 89.5 ng/mL respectively. We noted a significant association between HPV carriage and the two cytokines in our study (P = 0.00017 and P ˂ 0.0001 for TNF α and IL18 respectively) as the median concentrations of the two cytokines were significantly higher in participants infected with HPV compared with those who were not. Analysis of the area under the curve (AUC) values for TNF α (0.66) and IL18 (0.75) showed that IL18 was more sensitive than TNF α for the clinical prognosis of participants infected with HPV. This cytokine is a good marker for HPV infection in our study. In conclusion, this study highlights the high prevalence of HPV in young people and the extreme probability of exposure of the participants to cervical cancer. It calls for increased preventive action against HPV in this juvenile population.