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PC-10 Classical HLA alleles are associated with prevalent and persistent cervical high-risk HPV infection in African women

Background: Persistent cervical high-risk human papillomavirus (hrHPV) infection is a necessary cause of cervical cancer. However, the genetic factors underlying its risk are not well understood. We hypothesized that immunogenetic variation plays a role in hrHPV infection and persistence. Therefore, we conducted a study of classical HLA alleles and their association with hrHPV infection and persistence. Methods: We characterized HPV infection using SPF25/LiPA10 in Nigerian women at baseline and at 6 months follow-up visits in 2014. hrHPV infection was prevalent if at least one carcinogenic HPV genotype was detected in a sample provided at the baseline visit and persistent if at least one carcinogenic HPV genotype was detected in each of the samples provided at the baseline and follow-up visits. Genotyping was performed with the Illumina Multi-Ethnic Genotyping Array. Classical HLA alleles were imputed from genotypes in the MHC region using the HLA genotype imputation with attribute bagging (HIBAG) algorithm. HLA association tests were conducted under additive genetic models. P values were adjusted for multiple comparisons with the false discovery rate (FDR) method. Results: The mean (±SD) age of the study participants was 38 (±8) years, 48% (247/517) were HIV negative, 24% (125/517) were hrHPV positive at baseline and 10% (51/517) had persistent hrHPV infections. In multivariate regression models adjusted for age, HIV status and the first principal component, DQA1*01:02 (OR 1.46; 95% CI: 1.07 to 1.97; P = 0.03). and DQA1*02:01 (OR 1.89; 95% CI: 1.12 to 3.15; P = 0.03) were positively associated with prevalent but not persistent hrHPV infections, while DQA1*05:01 was negatively associated with prevalent hrHPV (OR 0.45; 95% CI: 0.24 to 0.85; P = 0.03) but positively associated with persistent cervical hrHPV infections (OR 2.46; 95% CI: 1.27 to 4.77; P = 0.04). Four haplotypes (A*30:01 - DQA1*05:01, B*07:02 - C*07:02, B*07:02 - DQA1*05:01 and C*07:02 - DQA1*05:01) were significantly associated with prevalent cervical hrHPV infections and several haplotypes that included the DQA1*05:01 allelic variant (including B*15:10 - DQA1*05:01, DQA1*05:01 - DQB1*02:01 and DQA1*05:01 - DRB1*03:01) were significantly associated with persistent cervical hrHPV infections. Six amino acids located on the DQA1 gene were associated with prevalent but not persistent cervical hrHPV infections. Conclusions: This study, the first to investigate the association between HLA alleles and persistent hrHPV risk in African women, has identified important risk alleles that merit further study. Our findings provide new insights into risk factors for hrHPV infection in women of African ancestry.