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Published in: BMC Infectious Diseases 1/2020

01-12-2020 | Human Papillomavirus | Research article

Prevalence of viral sexually transmitted infections and HPV high-risk genotypes in women in rural communities in the Department of La Paz, Bolivia

Authors: Marianela Patzi-Churqui, Katty Terrazas-Aranda, Jan-Åke Liljeqvist, Magnus Lindh, Kristina Eriksson

Published in: BMC Infectious Diseases | Issue 1/2020

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Abstract

Background

Bolivia has the highest prevalence of cervical cancer in South America and the prevalence of viral sexually transmitted infections (STIs) among people in urban cities is increasing. Little is known about the prevalence of viral STIs in rural communities, which generally have limited access to health care. In order to study the prevalence of viral STIs in rural Bolivia, we recruited women from villages and towns in the Department of La Paz in Bolivia.

Methods

Three hundred ninety-four female participants were assessed for IgG-antibodies to herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV) and hepatitis B virus (HBV, anti-HBc), as well as for the presence of HBV surface antigen (HBsAg) in dried blood spots. The prevalence of 12 high-risk types of human papillomavirus (HPV) was assessed by qPCR in dried cervicovaginal cell spots from 376 of these women. χ2 test was used to compare variables between the populations and binary logistic regression was used to identify risk factors associated with the positivity of the tests.

Results

The seroprevalence of HSV-2 was 53% and of HBV 10.3%. HBAg was detected in 15.8% of women with anti-HBV antibodies indicating chronic infection. The frequency of high-risk HPV infection was 27%, with the most prevalent high-risk HPV types being HPV 56, 39 and 31 followed by HPV 16 and 18. Finally, none of the 394 women were seropositive for HIV, and about 64% of the studied population was positive for at least one of the viral infections.

Conclusions

Women in Bolivian rural communities in La Paz show a high prevalence of HBV, HPV and, in particular, HSV-2. In contrast, none of the women were HIV positive, suggesting that the HIV prevalence in this population is low. The pattern of high-risk HPV types differed from many other countries with a predominance of HPV-types not included in the Gardasil vaccine which was officially introduced in Bolivia in April 2017.
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Literature
1.
go back to reference Ortayli N, Ringheim K, Collins L, Sladden T. Sexually transmitted infections: progress and challenges since the 1994 international conference on population and development (ICPD). Contraception. 2014;90(6 Suppl):S22–31.CrossRef Ortayli N, Ringheim K, Collins L, Sladden T. Sexually transmitted infections: progress and challenges since the 1994 international conference on population and development (ICPD). Contraception. 2014;90(6 Suppl):S22–31.CrossRef
2.
go back to reference Looker KJ, Magaret AS, Turner KME, Vickerman P, Gottlieb SL, Newman LM. Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012. PLoS One. 2015;10(1):e114989.CrossRef Looker KJ, Magaret AS, Turner KME, Vickerman P, Gottlieb SL, Newman LM. Global estimates of prevalent and incident herpes simplex virus type 2 infections in 2012. PLoS One. 2015;10(1):e114989.CrossRef
4.
go back to reference Montenegro RA, Stephens C. Indigenous health in Latin America and the Caribbean. Lancet. 2006;367(9525):1859–69.CrossRef Montenegro RA, Stephens C. Indigenous health in Latin America and the Caribbean. Lancet. 2006;367(9525):1859–69.CrossRef
5.
go back to reference Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.CrossRef Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359–86.CrossRef
7.
go back to reference Dzuba IG, Calderon R, Bliesner S, Luciani S, Amado F, Jacob M. A participatory assessment to identify strategies for improved cervical cancer prevention and treatment in Bolivia. Rev Panam Salud Publica. 2005;18(1):53–63.CrossRef Dzuba IG, Calderon R, Bliesner S, Luciani S, Amado F, Jacob M. A participatory assessment to identify strategies for improved cervical cancer prevention and treatment in Bolivia. Rev Panam Salud Publica. 2005;18(1):53–63.CrossRef
9.
go back to reference Parana R, Almeida D. HBV epidemiology in Latin America. J Clin Virol. 2005;34(Suppl 1):S130–3.CrossRef Parana R, Almeida D. HBV epidemiology in Latin America. J Clin Virol. 2005;34(Suppl 1):S130–3.CrossRef
10.
go back to reference Ropero Álvarez AM, Pérez-Vilar S, Pacis-Tirso C, Contreras M, El Omeiri N, Ruiz-Matus C, Velandia-González M. Progress in vaccination towards hepatitis B control and elimination in the region of the Americas. BMC Public Health. 2017;17(1):325.CrossRef Ropero Álvarez AM, Pérez-Vilar S, Pacis-Tirso C, Contreras M, El Omeiri N, Ruiz-Matus C, Velandia-González M. Progress in vaccination towards hepatitis B control and elimination in the region of the Americas. BMC Public Health. 2017;17(1):325.CrossRef
12.
go back to reference Terán Calderón C, Gorena Urizar D, González Blázquez C, Alejos Ferreras B, Ramírez Rubio O, Bolumar Montrull F, Ortiz Rivera M, del Amo VJ. Knowledge, attitudes and practices on HIV/AIDS and prevalence of HIV in the general population of Sucre, Bolivia. Braz J Infect Dis. 2015;19(4):369–75.CrossRef Terán Calderón C, Gorena Urizar D, González Blázquez C, Alejos Ferreras B, Ramírez Rubio O, Bolumar Montrull F, Ortiz Rivera M, del Amo VJ. Knowledge, attitudes and practices on HIV/AIDS and prevalence of HIV in the general population of Sucre, Bolivia. Braz J Infect Dis. 2015;19(4):369–75.CrossRef
14.
go back to reference Gruner N, Stambouli O, Ross RS. Dried blood spots--preparing and processing for use in immunoassays and in molecular techniques. J Vis Exp. 2015;97. Gruner N, Stambouli O, Ross RS. Dried blood spots--preparing and processing for use in immunoassays and in molecular techniques. J Vis Exp. 2015;97.
15.
go back to reference Kania D, Bekale AM, Nagot N, Mondain AM, Ottomani L, Meda N, Traore M, Ouedraogo JB, Ducos J, Van de Perre P, et al. Combining rapid diagnostic tests and dried blood spot assays for point-of-care testing of human immunodeficiency virus, hepatitis B and hepatitis C infections in Burkina Faso. West Africa Clin Microbiol Infect. 2013;19(12):E533–41.CrossRef Kania D, Bekale AM, Nagot N, Mondain AM, Ottomani L, Meda N, Traore M, Ouedraogo JB, Ducos J, Van de Perre P, et al. Combining rapid diagnostic tests and dried blood spot assays for point-of-care testing of human immunodeficiency virus, hepatitis B and hepatitis C infections in Burkina Faso. West Africa Clin Microbiol Infect. 2013;19(12):E533–41.CrossRef
16.
go back to reference Gustavsson I, Sanner K, Lindell M, Strand A, Olovsson M, Wikstrom I, Wilander E, Gyllensten U. Type-specific detection of high-risk human papillomavirus (HPV) in self-sampled cervicovaginal cells applied to FTA elute cartridge. J Clin Virol. 2011;51(4):255–8.CrossRef Gustavsson I, Sanner K, Lindell M, Strand A, Olovsson M, Wikstrom I, Wilander E, Gyllensten U. Type-specific detection of high-risk human papillomavirus (HPV) in self-sampled cervicovaginal cells applied to FTA elute cartridge. J Clin Virol. 2011;51(4):255–8.CrossRef
17.
go back to reference Ashley-Morrow R, Nollkamper J, Robinson NJ, Bishop N, Smith J. Performance of Focus ELISA tests for herpes simplex virus type 1 (HSV-1) and HSV-2 antibodies among women in ten diverse geographical locations. Clin Microbiol Infect. 2004;10(6):530–6.CrossRef Ashley-Morrow R, Nollkamper J, Robinson NJ, Bishop N, Smith J. Performance of Focus ELISA tests for herpes simplex virus type 1 (HSV-1) and HSV-2 antibodies among women in ten diverse geographical locations. Clin Microbiol Infect. 2004;10(6):530–6.CrossRef
18.
go back to reference García-Cisneros S, Sánchez-Alemán MÁ, Conde-Glez CJ, Lara-Zaragoza SJ, Herrera-Ortiz A, Plett-Torres T, Olamendi-Portugal M. Performance of ELISA and Western blot to detect antibodies against HSV-2 using dried blood spots. J Infect Public Health. 2019;12(2):224–8.CrossRef García-Cisneros S, Sánchez-Alemán MÁ, Conde-Glez CJ, Lara-Zaragoza SJ, Herrera-Ortiz A, Plett-Torres T, Olamendi-Portugal M. Performance of ELISA and Western blot to detect antibodies against HSV-2 using dried blood spots. J Infect Public Health. 2019;12(2):224–8.CrossRef
19.
go back to reference Gorander S, Mbwana J, Lyamuya E, Lagergard T, Liljeqvist JA. Mature glycoprotein g presents high performance in diagnosing herpes simplex virus type 2 infection in sera of different tanzanian cohorts. Clin Vaccine Immunol. 2006;13(6):633–9.CrossRef Gorander S, Mbwana J, Lyamuya E, Lagergard T, Liljeqvist JA. Mature glycoprotein g presents high performance in diagnosing herpes simplex virus type 2 infection in sera of different tanzanian cohorts. Clin Vaccine Immunol. 2006;13(6):633–9.CrossRef
20.
go back to reference Lindh M, Gorander S, Andersson E, Horal P, Mattsby-Balzer I, Ryd W. Real-time Taqman PCR targeting 14 human papilloma virus types. J Clin Virol. 2007;40(4):321–4.CrossRef Lindh M, Gorander S, Andersson E, Horal P, Mattsby-Balzer I, Ryd W. Real-time Taqman PCR targeting 14 human papilloma virus types. J Clin Virol. 2007;40(4):321–4.CrossRef
21.
go back to reference Machalek DA, Garland SM, Brotherton JML, Bateson D, McNamee K, Stewart M, Rachel Skinner S, Liu B, Cornall AM, Kaldor JM, et al. Very low prevalence of vaccine human papillomavirus types among 18- to 35-year old Australian women 9 years following implementation of vaccination. J Infect Dis. 2018;217(10):1590–600.CrossRef Machalek DA, Garland SM, Brotherton JML, Bateson D, McNamee K, Stewart M, Rachel Skinner S, Liu B, Cornall AM, Kaldor JM, et al. Very low prevalence of vaccine human papillomavirus types among 18- to 35-year old Australian women 9 years following implementation of vaccination. J Infect Dis. 2018;217(10):1590–600.CrossRef
22.
go back to reference Domercant JW, Jean Louis F, Hulland E, Griswold M, Andre-Alboth J, Ye T, Marston BJ. Seroprevalence of herpes simplex virus type-2 (HSV-2) among pregnant women who participated in a national HIV surveillance activity in Haiti. BMC Infect Dis. 2017;17(1):577.CrossRef Domercant JW, Jean Louis F, Hulland E, Griswold M, Andre-Alboth J, Ye T, Marston BJ. Seroprevalence of herpes simplex virus type-2 (HSV-2) among pregnant women who participated in a national HIV surveillance activity in Haiti. BMC Infect Dis. 2017;17(1):577.CrossRef
23.
go back to reference Rodriguez A, Castle P, Smith J, Bratti C, Hildesheim A, Schiffman M, Viscidi R, Burk R, Ashley R, Castellsague X, et al. A population based study of herpes simplex virus 2 seroprevalence in rural Costa Rica. Sex Transm Infect. 2003;79(6):460–5.CrossRef Rodriguez A, Castle P, Smith J, Bratti C, Hildesheim A, Schiffman M, Viscidi R, Burk R, Ashley R, Castellsague X, et al. A population based study of herpes simplex virus 2 seroprevalence in rural Costa Rica. Sex Transm Infect. 2003;79(6):460–5.CrossRef
24.
go back to reference Masson L, Arnold KB, Little F, Mlisana K, Lewis DA, Mkhize N, Gamieldien H, Ngcapu S, Johnson L, Lauffenburger DA, et al. Inflammatory cytokine biomarkers to identify women with asymptomatic sexually transmitted infections and bacterial vaginosis who are at high risk of HIV infection. Sex Transm Infect. 2016;92(3):186–93.CrossRef Masson L, Arnold KB, Little F, Mlisana K, Lewis DA, Mkhize N, Gamieldien H, Ngcapu S, Johnson L, Lauffenburger DA, et al. Inflammatory cytokine biomarkers to identify women with asymptomatic sexually transmitted infections and bacterial vaginosis who are at high risk of HIV infection. Sex Transm Infect. 2016;92(3):186–93.CrossRef
25.
go back to reference Cowan FM, French RS, Mayaud P, Gopal R, Robinson NJ, de Oliveira SA, Faillace T, Uusküla A, Nygård-Kibur M, Ramalingam S, et al. Seroepidemiological study of herpes simplex virus types 1 and 2 in Brazil, Estonia, India, Morocco, and Sri Lanka. Sex Transm Infect. 2003;79(4):286.CrossRef Cowan FM, French RS, Mayaud P, Gopal R, Robinson NJ, de Oliveira SA, Faillace T, Uusküla A, Nygård-Kibur M, Ramalingam S, et al. Seroepidemiological study of herpes simplex virus types 1 and 2 in Brazil, Estonia, India, Morocco, and Sri Lanka. Sex Transm Infect. 2003;79(4):286.CrossRef
26.
go back to reference Brazzale AG, Russell DB, Cunningham AL, Taylor J, McBride WJ. Seroprevalence of herpes simplex virus type 1 and type 2 among the indigenous population of Cape York, far North Queensland, Australia. Sex Health. 2010;7(4):453–9.CrossRef Brazzale AG, Russell DB, Cunningham AL, Taylor J, McBride WJ. Seroprevalence of herpes simplex virus type 1 and type 2 among the indigenous population of Cape York, far North Queensland, Australia. Sex Health. 2010;7(4):453–9.CrossRef
27.
go back to reference Daniels B, Wand H, Ramjee G. Prevalence of herpes simplex virus 2 (HSV-2) infection and associated risk factors in a cohort of HIV negative women in Durban. S Afr BMC Res Notes. 2016;9(1):1–8.CrossRef Daniels B, Wand H, Ramjee G. Prevalence of herpes simplex virus 2 (HSV-2) infection and associated risk factors in a cohort of HIV negative women in Durban. S Afr BMC Res Notes. 2016;9(1):1–8.CrossRef
28.
go back to reference Stieglitz J, Blackwell AD, Quispe Gutierrez R, Cortez Linares E, Gurven M, Kaplan H. Modernization, sexual risk-taking, and gynecological morbidity among Bolivian forager-horticulturalists. PLoS One. 2012;7(12):e50384.CrossRef Stieglitz J, Blackwell AD, Quispe Gutierrez R, Cortez Linares E, Gurven M, Kaplan H. Modernization, sexual risk-taking, and gynecological morbidity among Bolivian forager-horticulturalists. PLoS One. 2012;7(12):e50384.CrossRef
29.
go back to reference Zunzunegui MV, King MC, Coria CF, Charlet J. Male influences on cervical cancer risk. Am J Epidemiol. 1986;123(2):302–7.CrossRef Zunzunegui MV, King MC, Coria CF, Charlet J. Male influences on cervical cancer risk. Am J Epidemiol. 1986;123(2):302–7.CrossRef
30.
go back to reference Grabowski MK, Gray RH, Makumbi F, Kagaayi J, Redd AD, Kigozi G, Reynolds SJ, Nalugoda F, Lutalo T, Wawer MJ, et al. Use of injectable hormonal contraception and women's risk of herpes simplex virus type 2 acquisition: a prospective study of couples in Rakai, Uganda. Lancet Global Health. 3(8):e478–86.CrossRef Grabowski MK, Gray RH, Makumbi F, Kagaayi J, Redd AD, Kigozi G, Reynolds SJ, Nalugoda F, Lutalo T, Wawer MJ, et al. Use of injectable hormonal contraception and women's risk of herpes simplex virus type 2 acquisition: a prospective study of couples in Rakai, Uganda. Lancet Global Health. 3(8):e478–86.CrossRef
31.
go back to reference Lema CH, Hurtado LV, Segurondo D, Romero F, Dulon A, Asturizaga D, Panoso W, Garcia G, Fujiyoshi T, Yashiki S, et al. Human papillomavirus infection among Bolivian Amazonian women. Asian Pac J Cancer Prev. 2001;2(2):135–41.PubMed Lema CH, Hurtado LV, Segurondo D, Romero F, Dulon A, Asturizaga D, Panoso W, Garcia G, Fujiyoshi T, Yashiki S, et al. Human papillomavirus infection among Bolivian Amazonian women. Asian Pac J Cancer Prev. 2001;2(2):135–41.PubMed
33.
go back to reference Allende G, Surriabre P, Cáceres L, Bellot D, Ovando N, Torrico A, Calle P, Ascarrunz C, Alexander S, Bossens M, et al. Evaluation of the self-sampling for cervical cancer screening in Bolivia. BMC Public Health. 2019;19(1):80.CrossRef Allende G, Surriabre P, Cáceres L, Bellot D, Ovando N, Torrico A, Calle P, Ascarrunz C, Alexander S, Bossens M, et al. Evaluation of the self-sampling for cervical cancer screening in Bolivia. BMC Public Health. 2019;19(1):80.CrossRef
34.
go back to reference Castle PE, Schiffman M, Herrero R, Hildesheim A, Rodriguez AC, Bratti MC, Sherman ME, Wacholder S, Tarone R, Burk RD. A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica. J Infect Dis. 2005;191(11):1808–16.CrossRef Castle PE, Schiffman M, Herrero R, Hildesheim A, Rodriguez AC, Bratti MC, Sherman ME, Wacholder S, Tarone R, Burk RD. A prospective study of age trends in cervical human papillomavirus acquisition and persistence in Guanacaste, Costa Rica. J Infect Dis. 2005;191(11):1808–16.CrossRef
35.
go back to reference Munoz N, Franceschi S, Bosetti C, Moreno V, Herrero R, Smith JS, Shah KV, Meijer CJ, Bosch FX. Role of parity and human papillomavirus in cervical cancer: the IARC multicentric case-control study. Lancet. 2002;359(9312):1093–101.CrossRef Munoz N, Franceschi S, Bosetti C, Moreno V, Herrero R, Smith JS, Shah KV, Meijer CJ, Bosch FX. Role of parity and human papillomavirus in cervical cancer: the IARC multicentric case-control study. Lancet. 2002;359(9312):1093–101.CrossRef
36.
go back to reference Clifford GM, Gallus S, Herrero R, Munoz N, Snijders PJ, Vaccarella S, Anh PT, Ferreccio C, Hieu NT, Matos E, et al. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet. 2005;366(9490):991–8.CrossRef Clifford GM, Gallus S, Herrero R, Munoz N, Snijders PJ, Vaccarella S, Anh PT, Ferreccio C, Hieu NT, Matos E, et al. Worldwide distribution of human papillomavirus types in cytologically normal women in the International Agency for Research on Cancer HPV prevalence surveys: a pooled analysis. Lancet. 2005;366(9490):991–8.CrossRef
37.
go back to reference Ramqvist T, Du J, Lunden M, Ahrlund-Richter S, Ferreira J, Marions L, Sparen P, Andersson S, Dalianis T. Pre-vaccination prevalence of human papillomavirus types in the genital tract of 15-23-year-old women attending a youth health clinic in Stockholm. Sweden Scand J Infect Dis. 2011;43(2):115–21.CrossRef Ramqvist T, Du J, Lunden M, Ahrlund-Richter S, Ferreira J, Marions L, Sparen P, Andersson S, Dalianis T. Pre-vaccination prevalence of human papillomavirus types in the genital tract of 15-23-year-old women attending a youth health clinic in Stockholm. Sweden Scand J Infect Dis. 2011;43(2):115–21.CrossRef
38.
go back to reference Wheeler CM, Castellsagué X, Garland SM, Szarewski A, Paavonen J, Naud P, Salmerón J, Chow S-N, Apter D, Kitchener H, et al. Cross-protective efficacy of HPV-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by non-vaccine oncogenic HPV types: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial. Lancet Oncol. 2012;13(1):100–10.CrossRef Wheeler CM, Castellsagué X, Garland SM, Szarewski A, Paavonen J, Naud P, Salmerón J, Chow S-N, Apter D, Kitchener H, et al. Cross-protective efficacy of HPV-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by non-vaccine oncogenic HPV types: 4-year end-of-study analysis of the randomised, double-blind PATRICIA trial. Lancet Oncol. 2012;13(1):100–10.CrossRef
39.
go back to reference Jaramillo CM, de La Hoz F, Porras A, di Filippo D, Choconta-Piraquive LA, Payares E, Montes N, Navas M-C. Characterization of hepatitis B virus in Amerindian children and mothers from Amazonas state. Colombia PLoS One. 2017;12(10):e0181643.CrossRef Jaramillo CM, de La Hoz F, Porras A, di Filippo D, Choconta-Piraquive LA, Payares E, Montes N, Navas M-C. Characterization of hepatitis B virus in Amerindian children and mothers from Amazonas state. Colombia PLoS One. 2017;12(10):e0181643.CrossRef
40.
go back to reference Khan A, Tanaka Y, Saito H, Ebinuma H, Sekiguchi H, Iwama H, Wakabayashi G, Kamiya T, Kurbanov F, Elkady A, et al. Transmission of hepatitis B virus (HBV) genotypes among Japanese immigrants and natives in Bolivia. Virus Res. 2008;132(1):174–80.CrossRef Khan A, Tanaka Y, Saito H, Ebinuma H, Sekiguchi H, Iwama H, Wakabayashi G, Kamiya T, Kurbanov F, Elkady A, et al. Transmission of hepatitis B virus (HBV) genotypes among Japanese immigrants and natives in Bolivia. Virus Res. 2008;132(1):174–80.CrossRef
42.
go back to reference Li S, Wen X. Seropositivity to herpes simplex virus type 2, but not type 1 is associated with cervical cancer: NHANES (1999–2014). BMC Cancer. 2017;17(1):726.CrossRef Li S, Wen X. Seropositivity to herpes simplex virus type 2, but not type 1 is associated with cervical cancer: NHANES (1999–2014). BMC Cancer. 2017;17(1):726.CrossRef
43.
go back to reference Smith JS, Herrero R, Bosetti C, Muñoz N, Bosch FX, Eluf-Neto J, Castellsagué X, Meijer CJLM, Van den Brule AJC, Franceschi S, et al. Herpes simplex Virus-2 as a human papillomavirus cofactor in the etiology of invasive cervical Cancer. JNCI: J Natl Cancer Institute. 2002;94(21):1604–13.CrossRef Smith JS, Herrero R, Bosetti C, Muñoz N, Bosch FX, Eluf-Neto J, Castellsagué X, Meijer CJLM, Van den Brule AJC, Franceschi S, et al. Herpes simplex Virus-2 as a human papillomavirus cofactor in the etiology of invasive cervical Cancer. JNCI: J Natl Cancer Institute. 2002;94(21):1604–13.CrossRef
44.
go back to reference Zhao Y, Cao X, Zheng Y, Tang J, Cai W, Wang H, Gao Y, Wang Y. Relationship between cervical disease and infection with human papillomavirus types 16 and 18, and herpes simplex virus 1 and 2. J Med Virol. 2012;84(12):1920–7.CrossRef Zhao Y, Cao X, Zheng Y, Tang J, Cai W, Wang H, Gao Y, Wang Y. Relationship between cervical disease and infection with human papillomavirus types 16 and 18, and herpes simplex virus 1 and 2. J Med Virol. 2012;84(12):1920–7.CrossRef
Metadata
Title
Prevalence of viral sexually transmitted infections and HPV high-risk genotypes in women in rural communities in the Department of La Paz, Bolivia
Authors
Marianela Patzi-Churqui
Katty Terrazas-Aranda
Jan-Åke Liljeqvist
Magnus Lindh
Kristina Eriksson
Publication date
01-12-2020

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