High‐risk papillomavirus infection among women living with human Immunodeficiency virus: Brazilian multicentric study

Abstract

Cervical cancer is an important health issue in Latin America. Although HPV infections can have spontaneous clearance, persistence of high-risk (HR) HPV is a risk factor for cervical cancer among women and it is even higher in HIV-infected women. To determine the prevalence of HR-HPV and risk factors among HIV-infected women attending reference services for HIV/AIDS in different regions of Brazil. Cross-sectional study conducted among HIV-infected women attended at referral care centers for HIV/AIDS in nine states of Brazil. Women from 18 to 49 years that accept to participate and were not pregnant at the time of the approach were recruited for the study. The HPV screening was realized using qPCR in closed system, in vitro Diagnostic, COBAS -HPV Roche. The cytology results were available by the Bethesda System. A total of 802(89.1%) from the selected women agreed to participate in the study. Median age was 39(Inter quartile range [IQR34-46]) years and median education was 9(IQR6-11) years. General prevalence of HR-HPV was 28.4%(228/802). HPV-16 prevalence rate was 8.1%(65/802), HPV-18 was 3.7%(30/802) and other types of HR-HPV were 23.6% (189/802). Risk factors for HR-HPV infection in the multivariate logistic regression analysis were: age ranging from 18 to 34 years (OR = 1.43[95%CI:1.18-1.75]), illicit drugs use (OR = 1.61[95%CI:1.10-2.42]) and abnormal cervical cytology (OR = 1.56[95%CI:1.34-1.81]). Results showed a prevalence rate of 28.4% of HR-HPV infection in women living with HIV in Brazil. These infections were significantly associated with having less than 35 years old, illicit drug use and abnormal cervical cytology.

Brazilian Protocol for Sexually Transmitted Infections 2020: human papillomavirus (HPV) infection

“…People living with HIV report a higher frequency of multiple infections, anogenital warts, intraepithelial lesions, and anogenital neoplasms due to HPV infection 18 , 19 . These data were confirmed in Brazil in a study by Miranda et al, and a 28.4% prevalence of high-risk HPV was found, in addition to the association with cytological abnormalities, age under 35, and illicit drug use 20 .…”

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: infecção pelo papilomavírus humano (HPV)

“…18,19 Estos datos fueron confirmados en Brasil, en un estudio de Miranda et al, con una prevalencia de 28, 4% PVH de alto riesgo, además de asociación con anomalías citológicas, edad menor a 35 años y uso de drogas ilícitas. 20…”

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

“…A multi-center study conducted by Miranda et al in Brazil, which considered the prevalence of HPV lesions in 802 women, had results close to ours with a prevalence of 28.4%. 17 Nevertheless, Silva Martins and colleagues described a more comprehensive cohort in a study involving three Brazilian research centers. In that study, about 450 HIVpositive women were recruited and studied using oncologic cytology, colposcopy with biopsy, and viral typing with PCR.…”