The past, present and future impact of HIV prevention and control on HPV and cervical disease in Tanzania: A modelling study
Women with HIV have an elevated risk of HPV infection, and eventually, cervical cancer. Tanzania has a high burden of both HIV and cervical cancer, with an HIV prevalence of 5.5% in women in 2018, and a cervical cancer incidence rate among the highest globally, at 59.1 per 100,000 per year, and an e...
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| description | Women with HIV have an elevated risk of HPV infection, and eventually, cervical cancer. Tanzania has a high burden of both HIV and cervical cancer, with an HIV prevalence of 5.5% in women in 2018, and a cervical cancer incidence rate among the highest globally, at 59.1 per 100,000 per year, and an estimated 9,772 cervical cancers diagnosed in 2018. We aimed to quantify the impact that interventions intended to control HIV have had and will have on cervical cancer in Tanzania over a period from 1995 to 2070.
A deterministic transmission-dynamic compartment model of HIV and HPV infection and natural history was used to simulate the impact of voluntary medical male circumcision (VMMC), anti-retroviral therapy (ART), and targeted pre-exposure prophylaxis (PrEP) on cervical cancer incidence and mortality from 1995-2070.
We estimate that VMMC has prevented 2,843 cervical cancer cases and 1,039 cervical cancer deaths from 1995-2020; by 2070 we predict that VMMC will have lowered cervical cancer incidence and mortality rates by 28% (55.11 cases per 100,000 women in 2070 without VMMC, compared to 39.93 with VMMC only) and 26% (37.31 deaths per 100,000 women in 2070 without VMMC compared to 27.72 with VMMC), respectively. We predict that ART will temporarily increase cervical cancer diagnoses and deaths, due to the removal of HIV death as a competing risk, but will ultimately further lower cervical cancer incidence and mortality rates by 7% (to 37.31 cases per 100,000 women in 2070) and 5% (to 26.44 deaths per 100,000 women in 2070), respectively, relative to a scenario with VMMC but no ART. A combination of ART and targeted PrEP use is anticipated to lower cervical cancer incidence and mortality rates to 35.82 and 25.35 cases and deaths, respectively, per 100,000 women in 2070.
HIV treatment and control measures in Tanzania will result in long-term reductions in cervical cancer incidence and mortality. Although, in the near term, the life-extending capability of ART will result in a temporary increase in cervical cancer rates, continued efforts towards HIV prevention will reduce cervical cancer incidence and mortality over the longer term. These findings are critical background to understanding the longer-term impact of achieving cervical cancer elimination targets in Tanzania. |
| doi_str_mv | 10.1371/journal.pone.0231388 |
| format | Article |
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A deterministic transmission-dynamic compartment model of HIV and HPV infection and natural history was used to simulate the impact of voluntary medical male circumcision (VMMC), anti-retroviral therapy (ART), and targeted pre-exposure prophylaxis (PrEP) on cervical cancer incidence and mortality from 1995-2070.
We estimate that VMMC has prevented 2,843 cervical cancer cases and 1,039 cervical cancer deaths from 1995-2020; by 2070 we predict that VMMC will have lowered cervical cancer incidence and mortality rates by 28% (55.11 cases per 100,000 women in 2070 without VMMC, compared to 39.93 with VMMC only) and 26% (37.31 deaths per 100,000 women in 2070 without VMMC compared to 27.72 with VMMC), respectively. We predict that ART will temporarily increase cervical cancer diagnoses and deaths, due to the removal of HIV death as a competing risk, but will ultimately further lower cervical cancer incidence and mortality rates by 7% (to 37.31 cases per 100,000 women in 2070) and 5% (to 26.44 deaths per 100,000 women in 2070), respectively, relative to a scenario with VMMC but no ART. A combination of ART and targeted PrEP use is anticipated to lower cervical cancer incidence and mortality rates to 35.82 and 25.35 cases and deaths, respectively, per 100,000 women in 2070.
HIV treatment and control measures in Tanzania will result in long-term reductions in cervical cancer incidence and mortality. Although, in the near term, the life-extending capability of ART will result in a temporary increase in cervical cancer rates, continued efforts towards HIV prevention will reduce cervical cancer incidence and mortality over the longer term. These findings are critical background to understanding the longer-term impact of achieving cervical cancer elimination targets in Tanzania.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0231388</identifier><identifier>PMID: 32374729</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Antiretroviral agents ; Antiretroviral therapy ; Biology and Life Sciences ; Cancer ; Cancer diagnosis ; Cancer prevention ; Cervical cancer ; Cervix ; Circumcision ; Computer simulation ; Diseases ; Fatalities ; Health risk assessment ; Health risks ; HIV ; HIV infections ; Human immunodeficiency virus ; Human papillomavirus ; Infection ; Infection control ; Infections ; Medical research ; Medicine and Health Sciences ; Mortality ; Prevention ; Prophylaxis ; Sexually transmitted disease prevention ; Statistics</subject><ispartof>PloS one, 2020-05, Vol.15 (5), p.e0231388-e0231388</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Hall et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Hall et al 2020 Hall et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-6404b31da05c24297bf44d7247495588399bf03b7f8cbd78d78db2527d419d2b3</citedby><cites>FETCH-LOGICAL-c692t-6404b31da05c24297bf44d7247495588399bf03b7f8cbd78d78db2527d419d2b3</cites><orcidid>0000-0002-8989-1449 ; 0000-0002-6443-6618</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202618/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7202618/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32374729$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>d’Onofrio, Alberto</contributor><creatorcontrib>Hall, Michaela T</creatorcontrib><creatorcontrib>Smith, Megan A</creatorcontrib><creatorcontrib>Simms, Kate T</creatorcontrib><creatorcontrib>Barnabas, Ruanne V</creatorcontrib><creatorcontrib>Canfell, Karen</creatorcontrib><creatorcontrib>Murray, John M</creatorcontrib><title>The past, present and future impact of HIV prevention and control on HPV and cervical disease in Tanzania: A modelling study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Women with HIV have an elevated risk of HPV infection, and eventually, cervical cancer. Tanzania has a high burden of both HIV and cervical cancer, with an HIV prevalence of 5.5% in women in 2018, and a cervical cancer incidence rate among the highest globally, at 59.1 per 100,000 per year, and an estimated 9,772 cervical cancers diagnosed in 2018. We aimed to quantify the impact that interventions intended to control HIV have had and will have on cervical cancer in Tanzania over a period from 1995 to 2070.
A deterministic transmission-dynamic compartment model of HIV and HPV infection and natural history was used to simulate the impact of voluntary medical male circumcision (VMMC), anti-retroviral therapy (ART), and targeted pre-exposure prophylaxis (PrEP) on cervical cancer incidence and mortality from 1995-2070.
We estimate that VMMC has prevented 2,843 cervical cancer cases and 1,039 cervical cancer deaths from 1995-2020; by 2070 we predict that VMMC will have lowered cervical cancer incidence and mortality rates by 28% (55.11 cases per 100,000 women in 2070 without VMMC, compared to 39.93 with VMMC only) and 26% (37.31 deaths per 100,000 women in 2070 without VMMC compared to 27.72 with VMMC), respectively. We predict that ART will temporarily increase cervical cancer diagnoses and deaths, due to the removal of HIV death as a competing risk, but will ultimately further lower cervical cancer incidence and mortality rates by 7% (to 37.31 cases per 100,000 women in 2070) and 5% (to 26.44 deaths per 100,000 women in 2070), respectively, relative to a scenario with VMMC but no ART. A combination of ART and targeted PrEP use is anticipated to lower cervical cancer incidence and mortality rates to 35.82 and 25.35 cases and deaths, respectively, per 100,000 women in 2070.
HIV treatment and control measures in Tanzania will result in long-term reductions in cervical cancer incidence and mortality. Although, in the near term, the life-extending capability of ART will result in a temporary increase in cervical cancer rates, continued efforts towards HIV prevention will reduce cervical cancer incidence and mortality over the longer term. These findings are critical background to understanding the longer-term impact of achieving cervical cancer elimination targets in Tanzania.</description><subject>Antiretroviral agents</subject><subject>Antiretroviral therapy</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Cancer diagnosis</subject><subject>Cancer prevention</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Circumcision</subject><subject>Computer simulation</subject><subject>Diseases</subject><subject>Fatalities</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV infections</subject><subject>Human immunodeficiency virus</subject><subject>Human papillomavirus</subject><subject>Infection</subject><subject>Infection control</subject><subject>Infections</subject><subject>Medical research</subject><subject>Medicine and Health 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Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hall, Michaela T</au><au>Smith, Megan A</au><au>Simms, Kate T</au><au>Barnabas, Ruanne V</au><au>Canfell, Karen</au><au>Murray, John M</au><au>d’Onofrio, Alberto</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The past, present and future impact of HIV prevention and control on HPV and cervical disease in Tanzania: A modelling study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-05-06</date><risdate>2020</risdate><volume>15</volume><issue>5</issue><spage>e0231388</spage><epage>e0231388</epage><pages>e0231388-e0231388</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Women with HIV have an elevated risk of HPV infection, and eventually, cervical cancer. Tanzania has a high burden of both HIV and cervical cancer, with an HIV prevalence of 5.5% in women in 2018, and a cervical cancer incidence rate among the highest globally, at 59.1 per 100,000 per year, and an estimated 9,772 cervical cancers diagnosed in 2018. We aimed to quantify the impact that interventions intended to control HIV have had and will have on cervical cancer in Tanzania over a period from 1995 to 2070.
A deterministic transmission-dynamic compartment model of HIV and HPV infection and natural history was used to simulate the impact of voluntary medical male circumcision (VMMC), anti-retroviral therapy (ART), and targeted pre-exposure prophylaxis (PrEP) on cervical cancer incidence and mortality from 1995-2070.
We estimate that VMMC has prevented 2,843 cervical cancer cases and 1,039 cervical cancer deaths from 1995-2020; by 2070 we predict that VMMC will have lowered cervical cancer incidence and mortality rates by 28% (55.11 cases per 100,000 women in 2070 without VMMC, compared to 39.93 with VMMC only) and 26% (37.31 deaths per 100,000 women in 2070 without VMMC compared to 27.72 with VMMC), respectively. We predict that ART will temporarily increase cervical cancer diagnoses and deaths, due to the removal of HIV death as a competing risk, but will ultimately further lower cervical cancer incidence and mortality rates by 7% (to 37.31 cases per 100,000 women in 2070) and 5% (to 26.44 deaths per 100,000 women in 2070), respectively, relative to a scenario with VMMC but no ART. A combination of ART and targeted PrEP use is anticipated to lower cervical cancer incidence and mortality rates to 35.82 and 25.35 cases and deaths, respectively, per 100,000 women in 2070.
HIV treatment and control measures in Tanzania will result in long-term reductions in cervical cancer incidence and mortality. Although, in the near term, the life-extending capability of ART will result in a temporary increase in cervical cancer rates, continued efforts towards HIV prevention will reduce cervical cancer incidence and mortality over the longer term. These findings are critical background to understanding the longer-term impact of achieving cervical cancer elimination targets in Tanzania.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32374729</pmid><doi>10.1371/journal.pone.0231388</doi><tpages>e0231388</tpages><orcidid>https://orcid.org/0000-0002-8989-1449</orcidid><orcidid>https://orcid.org/0000-0002-6443-6618</orcidid><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Antiretroviral agents Antiretroviral therapy Biology and Life Sciences Cancer Cancer diagnosis Cancer prevention Cervical cancer Cervix Circumcision Computer simulation Diseases Fatalities Health risk assessment Health risks HIV HIV infections Human immunodeficiency virus Human papillomavirus Infection Infection control Infections Medical research Medicine and Health Sciences Mortality Prevention Prophylaxis Sexually transmitted disease prevention Statistics |
| title | The past, present and future impact of HIV prevention and control on HPV and cervical disease in Tanzania: A modelling study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T05%3A07%3A16IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20past,%20present%20and%20future%20impact%20of%20HIV%20prevention%20and%20control%20on%20HPV%20and%20cervical%20disease%20in%20Tanzania:%20A%20modelling%20study&rft.jtitle=PloS%20one&rft.au=Hall,%20Michaela%20T&rft.date=2020-05-06&rft.volume=15&rft.issue=5&rft.spage=e0231388&rft.epage=e0231388&rft.pages=e0231388-e0231388&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0231388&rft_dat=%3Cgale_plos_%3EA622865109%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2399252441&rft_id=info:pmid/32374729&rft_galeid=A622865109&rft_doaj_id=oai_doaj_org_article_9063899b348547ba9c4cc8dcad9a3fb9&rfr_iscdi=true |