Cervical and oropharyngeal human papillomavirus infection in women living with human immunodeficiency virus (HIV) and matched HIV-negative controls in Brazil

Abstract

Background: Despite the demonstrated role of human Papillomavirus (HPV) in the etiology of cervical cancer and the strong evidence suggesting the importance of HPV in the development of oropharyngeal cancer, several aspects concerning the interrelationship between HPV infections in both body sites remain unknown, specifically in human immunodeficiency virus (HIV)-positive (HIV+) female patients. We aimed to assess the prevalence, distribution, and concordance of cervical and oropharyngeal HPV in HIV+ women and matched HIV-negative (HIV-) controls in Brazil. Material and methods: Cervical and endocervical samples for cytological screening and HPV detection and oropharyngeal samples were collected from 115 HIV+ women using highly active antiretroviral therapy (HAART) and 139 HIV-matched controls (HIV-) in Maringá City, Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding HIV infection were obtained from the patients’ medical records. Detection and typing of HPV were performed using the Kit Multiplex XGEN Multi HPV Chip HS12. Results: HIV infection was well controlled in this cohort, but women who exhibited 1–100.000 viral copies/mL were significantly associated with HPV-positive status (P = 0.03). HIV+ women had significantly more abnormal cytological findings (P = 0.04) than HIV- women. Of the 115 HIV+ women, 48.7% were positive for cervical and/or oropharyngeal HPV DNA; of the 139 HIV- women, 41% were positive for cervical and/or oropharyngeal HPV (P = 0.25). Both HIV+ and HIV- women had a statistically higher prevalence of cervical HPV infection than oropharyngeal infection. The concurrent HPV infection in two anatomical sites was similar in HIV+ and HIV- women, however HPV type concordance was not observed. HPV type distribution was different between the anatomical sites in both groups, and HIV+ women presented types less common, mainly in oropharyngeal mucosa. Conclusion: Our data support the importance of HPV infection in HIV+ women, even when the HIV infection is well controlled. Prospective studies are required to better understand the natural history of HPV infection in both anatomical sites, specifically in HIV+ women.