Abstract
BackgroundHIV infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being HPV. However, studies are needed for determining associations between immunodeficiency caused by HIV and/or the presence of HPV during the course of cervical lesions and their degree of malignancy. This study describes the cytological findings revealed by the Papanicolaou test, laboratory characteristics and HPV molecular profile in women with and without HIV infection.MethodsA total of 216 HIV-positive and 1,159 HIV-negative women were invited to participate in the study; PCR was used for the molecular detection of HPV in cervical samples. Statistical analysis (such as percentages, Chi-square test and Fisher’s exact test when applicable) determined human papillomavirus (HPV) infection frequency (single and multiple) and the distribution of six types of high-risk-HPV in women with and without HIV infection. Likewise, a logistic regression model was run to evaluate the relationship between HIV-HPV infection and different risk factors.ResultsAn association was found between the frequency of HPV infection and infection involving 2 or more HPV types (also known as multiple HPV infection) in HIV-positive women (69.0% and 54.2%, respectively); such frequency was greater than that found in HIV-negative women (44.3% and 22.7%, respectively). Statistically significant differences were observed between both groups (p = 0.001) regarding HPV presence (both in infection and multiple HPV infection). HPV-16 was the most prevalent type in the population being studied (p = 0.001); other viral types had variable distribution in both groups (HIV-positive and HIV-negative). HPV detection was associated with <500 cell/mm3 CD4-count (p = 0.004) and higher HIV-viral-load (p = 0.001). HPV-DNA detection, <200 cell/mm3 CD4-count (p = 0.001), and higher HIV-viral-load (p = 0.001) were associated with abnormal cytological findings.ConclusionsThe HIV-1 positive population in this study had high multiple HPV infection prevalence. The results for this population group also suggested a greater association between HPV-DNA presence and cytological findings. HPV detection, together with low CD4 count, could represent useful tools for identifying HIV-positive women at risk of developing cervical lesions.
Highlights
human immunodeficiency virus (HIV) infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being human papillomavirus (HPV)
The resulting information has contributed towards knowledge regarding HIV-HPV-related sexually-transmitted infections
216 of the women were HIV-positive whose ages ranged from 20–73 years old (SD = 10.7; mean age = 37.5: 36.0-38.9 95% Confidence interval (CI)) and a second group consisted of 1,159 HIV-negative women aged 14–76 (SD = 11.0; mean age = 36.8: 36.1-37.4 95% confidence intervals (95% CI))
Summary
HIV infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being HPV. Fifteen of the viral types identified to date have been classified as HR-HPV (HRHPV-16, −18, −45, −31, −33, −52, −58 and −35 having the highest frequency) [1]. This type of cancer accounts for the second cause of death by malignant neoplasia in women, primarily those of childbearing age and living in developing countries. One of the most studied types of immunosuppression is that due to human immunodeficiency virus (HIV) infection [6] Such infection leads to alterations in cellmediated immunity, thereby facilitating the acquisition of opportunistic infections and limiting an organism’s ability to produce an efficient immune response [7]
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