Association of plasma afatoxin with persistent detection of oncogenic human papillomaviruses in cervical samples from Kenyan women enrolled in a longitudinal study

Abstract

Background Cervical cancer is caused by oncogenic human papillomaviruses (HR-HPV) and is common among Kenyan women. Identification of factors that increase HR-HPV persistence is critically important. Kenyan women exposed to afatoxin have an increased risk of HR-HPV detection in cervical specimens. This analysis was performed to examine associations between afatoxin and HR-HPV persistence. Methods Kenyan women were enrolled in a prospective study. The analytical cohort for this analysis included 67 HIV uninfected women (mean age 34 years) who completed at least two of three annual study visits and had an available blood sample. Plasma afatoxin was detected using ultra-high pressure liquid chromatography (UHPLC)-isotope dilution mass spectrometry. Annual cervical swabs were tested for HPV (Roche Linear Array). Ordinal logistic regression models were ftted to examine associations of afatoxin and HPV persistence. Results Afatoxin was detected in 59.7% of women and was associated with higher risk of persistent detection of any HPV type (OR=3.03, 95%CI=1.08–8.55, P=0.036), HR-HPV types (OR=3.63, 95%CI=1.30-10.13, P=0.014), and HR HPV types not included in the 9-valent HPV vaccine (OR=4.46, 95%CI=1.13–17.58, P=0.032). Conclusions Afatoxin detection was associated with increased risk of HR-HPV persistence in Kenyan women. Further studies, including mechanistic studies are needed to determine if afatoxin synergistically interacts with HR-HPV to increase cervical cancer risk.