Cervical HPV infection in Romanian women infected with HIV during early childhood

Abstract

Human papillomavirus (HPV) is the most common cause of cervical cancer worldwide, and Romania has the highest rate of cervical cancer in Europe. Sixty-five young Romanian women infected with HIV during early childhood and 25 control subjects were evaluated for the presence of cervical HPV infection and for cytologic abnormalities. HPV infection was evaluated longitudinally in 42 HIV-infected individuals. Overall 28/65 (43.1%) of HIV-infected and 8/25 (32.0%) of uninfected subjects were infected with HPV, and 21/65 (32.3%) and 6/25 (24%) had high-risk subtypes, respectively. In HIV-infected women, those maintaining or acquiring a new subtype in follow-up were more likely to have a lower nadir ( p = 0.04) and current ( p = 0.01) CD4 cell counts. The incidence rate for HPV acquisition events was 0.69 per subject per year, and 0.52 for high-risk subtypes. In the HIV-infected group, 9/13 (69.2%) individuals with abnormal cytology progressed at follow-up. Although HPV prevalence was similar to controls, the rate of Pap smear abnormalities was much higher, possibly due to the decreased ability to mount new immune responses. Given the high rate of incident detection of vaccine preventable strains and cytologic progression in this cohort, HPV vaccination may be beneficial at any age in co-infected women.

Risk Factors for Human Papillomavirus Infection and Abnormal Cervical Cytology Among Perinatally Human Immunodeficiency Virus-Infected and Uninfected Asian Youth

“…The scale of this difference emphasizes the greater vulnerability of Asian PHIV adolescents to longterm cancer risk. One-third of our adolescents had abnormal cervical cytology, which was consistent with an earlier US PHIV cohort (30%; mean age 19 years) [23] but higher than a parenterally infected Romanian cohort (25%; mean age 23 years) [24]. Furthermore, on colposcopy, condyloma acuminata and CIN 1 and CIN 3 on either visual inspection or biopsy were only detected among PHIV participants (42% vs 0% of those evaluated), raising concerns about the relative severity of disease they experience.…”

Knowledge about cervical cancer and barriers toward cervical cancer screening among HIV‐positive women attending public health centers in Addis Ababa city, Ethiopia

“…Half of 294 (50.6%) of the study participants said cervical cancer is preventable, which is substantially higher compared to findings in other settings. Much lower proportion was reported in Johannesburg, Burkina Faso, and LAO PDR [27][28][29]. These variations may in part reflect differences in awareness creation strategies, including the extent of media coverage, and as well as cultural differences.…”

Human papillomavirus prevalence, genomic diversity and related risk factors in HIV-positive women from a countryside city in the state of Rio de Janeiro

“…Other studies have also shown that HIV-positive women have a higher frequency of multiple HPV infections and greater genotypic diversity, but have a tendency for greater distribution of oncogenic viral types, mainly 16, 18, 31, 33 and 45. [24][25][26] Similarly, Castilho and colleagues published hrHPV prevalence results of 65% in a cohort of 590 HIV-positive women by using hybrid capture-based genome testing. Besides, they also showed that 32% of the women studied had more than one type of high-risk HPV detected.…”