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The HPV and STIs Training Centre for Africa

HPV laboratory_Easy-Resize.comIn many African countries there is limited data on the circulating HPV types causing anal, oral and cervical benign lesions, pre-cancerous and cancerous lesions. This is due to lack of expertise and capacity (resources) to detect and genotype HPV.  What is more important is the collapsed or non-exciting cervical cancer screening programs and the lack of baseline epidemiological data on the circulating HPV types in most of the African countries. These have led to the establishment of the HPV and STIs training centre for Africa through funding from the VLIR UOS North South Africa Cooperation programme.

The HPV and STIs Training Centre for Africa was established and launched at SMU in 2015 and it is housed at the Department of Virological Pathology. The mandate of centre is to train scientists, cytotechnologists, cytotechnicians and clinicians and pathologist. To perform HPV testing and genotyping and cytology from all the studies in project 4 of VLIR-IUC, from other private or public institutions and international partner countries within the WAKA Network and also from the neighbouring universities in need of these services. The centre has received PANTHER system (Pictured) as a donation from Hologic (Ilex SA) and ThinPrep T5000 cytology system (Separation Scientific) through the assistance of Prof Bogers who led the negotiations and discussions with Hologic.

The PANTHER System is a fully automated system that integrated nucleic acid testing system that fully automates all steps necessary to perform the APTIMA assays from sample processing through amplification, detection, and data reduction. Hologic’s Aptima HPV mRNA based assay is a nucleic acid amplified test that detects 14 high-risk strains of HPV associated with cervical cancer and precancerous lesions. It is a clinically proven diagnostic tool that helps healthcare providers more accurately assess a patient’s risk of developing cervical cancer. ThinPrep T5000 system delivers a fully automated processing option for ThinPrep non-gynaecology or UroCyte samples. Utilizing the ThinPrep slide preparation technology the ThinPrep 5000 system processes up to 20 samples per batch. ThinPrep 5000 is a true walk-away processor, significantly reducing the hands-on time required to process specimens.

This test is not yet rolled out into the national program for cervical cancer screening in South Africa however it has been showed to be more sensitive than the present screening method (Pap Test).  VLIR_UIC funded the procurement of a BioPlex MagPix Multiplex Luminex system costing R600 000 from Bio-rad. This multiplex technology is highly sensitive and based on fluorescent bead technology, and allows simultaneous detection of nucleic acids against up to 50 different HPV types in single reaction volume. For this project collaboration with Dr. Massimo Tomassino from the IARC/WHO (Lyon, France) was set up.

Setting up this centre is a continuous process and it is possible through the support of WAKA HPV AFRICA network, VLIR-UOS North South South Cooperation Programme, VLIR-IUC, Hologic (Ilex and Separation Scientific), and Department of Virology, Department of Microbiology and Department of Anatomical Pathology and most importantly Sefako Makgatho Health Sciences University management.

Currently within VLIR projects we are conducting in MeCru clinic in collaboration with other Departments, we are investigating HPV infection and other STIs in man who have sex with men from North West regions. Recruitment of participants have started and cytology together with HPV testing has been performed on the samples collected thus far. Multicenter study also under VLIR-IUC SMU projects is also underway. The study is based on self-collection of samples and Doctor taken liquid based cytology to compare cytology and HPV infection in these two different samples from participants from Ga-Dikgale in Polokwane and from three clinics in DGMAH under Gynecology and Obstetrics Department.

Dr Lebelo (Head of the HPV and STIs Training centre for Africa) co-lead a project called North South South VLIR-UOS which involves other African countries working on HPV and cervical cancer research and Prof SG Selabe is the WAKA South African coordinator. The mandate of this program is to share information on the cervical cancer screening, HPV testing and genotyping and to assist with writing of proposals, reports and manuscripts in the human papillomavirus research field in these African countries. At the moment we have performed cytology on liquid based cytology on 1000 samples and performed HPV genotyping in 250 of these samples from Democratic Republic of Congo. We have also performed cytology and HPV genotyping on 300 samples from Burundi. We have started a PhD project that investigates HPV infection in the oropharyngeal cavity and also comparing with cytology and oral clinical examination. Thus far over 100 patients have been recruited and 3 samples collected by oral brush and oral rinse