Human papillomavirus infection in a population‐based sample of women in Algiers,Algeria

No data exist on the population prevalence of, nor risk factors for, human papillomavirus (HPV) infection in the predominantly Muslim countries of Northern Africa. Cervical specimens were obtained from 759 married women aged 15–65 years from the general population of Algiers, Algeria. Liquid‐based cytology and HPV DNA detection, using a GP5+/6+‐based polymerase chain reaction assay that detects 44 HPV types, were performed according to the standardized protocol of the International Agency for Research on Cancer HPV Prevalence Surveys. HPV prevalence in the general population was 6.3% (4.0% of high‐risk types), with no significant variation by age. The prevalence of cervical abnormalities was 3.6%. HPV positivity was significantly higher among divorced women, women in polygamous marriages and those reporting husband's extramarital sexual relationships. HPV16/18 accounted for only 15% of HPV‐positive women in the general population, compared with 77% of invasive cervical cancer diagnosed in the same city. In conclusion, we report that HPV infection among married women in Algeria is much lower than in sub‐Saharan Africa and also lower than in the majority of high‐resource countries.     

Meta-analyses of FibroTest diagnostic value in chronic liver disease

Background

FibroTest (FT) is a biomarker of liver fibrosis initially validated in patients with chronic hepatitis C (CHC). The aim was to test two hypotheses, one, that the FT diagnostic value was similar in the three other frequent fibrotic diseases: chronic hepatitis B (CHB), alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD); and the other, that the FT diagnostic value was similar for intermediate and extreme fibrosis stages.

Methods

The main end points were the FT area under the ROC curves (AUROCs) for the diagnosis of bridging fibrosis (F2F3F4 vs. F0F1), standardized for the spectrum of fibrosis stages, and the comparison of FT AUROCs between adjacent stages. Two meta-analyses were performed: one combining all the published studies (random model), and one of an integrated data base combining individual data. Sensitivity analysis integrated the independency of authors, lenght of biopsy, prospective design, respect of procedures, comorbidities, and duration between biopsy and serum sampling.

Results

A total of 30 studies were included which pooled 6,378 subjects with both FT and biopsy (3,501 HCV, 1,457 HBV, 267 NAFLD, 429 ALD, and 724 mixed). Individual data were analyzed in 3,282 patients. The mean standardized AUROC was 0.84 (95% CI, 0.83–0.86), without differences between causes of liver disease: HCV 0.85 (0.82–0.87), HBV 0.80 (0.77–0.84), NAFLD 0.84 (0.76–0.92), ALD 0.86 (0.80–0.92), mixed 0.85 (0.80–0.93). The AUROC for the diagnosis of the intermediate adjacent stages F2 vs. F1 (0.66; 0.63–0.68, n = 2,055) did not differ from that of the extreme stages F3 vs. F4 (0.69; 0.65–0.72, n = 817) or F1 vs. F0 (0.62; 0.59–0.65, n = 1788).

Conclusion

FibroTest is an effective alternative to biopsy in patients with chronic hepatitis C and B, ALD and NAFLD. The FT diagnostic value is similar for the diagnosis of intermediate and extreme fibrosis stages.