HIV+ Status and Cervical Cancer: Cytological Aspects of Cervical Smear in Cameroon Setting

Abstract

Introduction: The early detection of precancerous lesions being very important for the preventive management of cervical cancer, we felt it was important to identify these lesions on potential backgrounds including HIV-positive (HIV+) women to suggest control strategies of cervical cancer in Cameroon. Objective: To determine the prevalence of precancerous lesions in women infected with the human immunodeficiency virus (HIV), to investigate the determinants of the HIV and cervical cancer association, and to make recommendations regarding cervical cancer screening in these patients of the city of Douala. Methodology: Our study was a case-control cross-sectional study from July 2017 to December 2017 (6 months) including 108 women among which 34 HIV+ matched with 74 HIV−. HIV serology was done using the complete HIV enzygnost test. Cervical smears for cytological lesions were fixed to the cyto-fixator and then stained by the Papanicolaou technique and read under an optical microscope. The cervical smear slides for viral excretion were fixed with a methanol-acetone mixture of equal volume; HPV testing was done by the indirect immune-peroxidase technique using P16 protein. The excretion of HSV type 1 & 2 was investigated by the indirect immunofluorescence technique using the Simplex Virus type 1 & 2 Rabbit anti-Herpes from DAKO (France). Results: The two groups of women were compared with the chi square test with a significance threshold of P < 0.05. The average age was 40.07 with extremes of 21 and 71 years and a standard deviation of 9.99. Of the 34 HIV+ patients, 23 had an abnormal cervix compared to 36 cases of abnormal cervix among HIV− with a statistically significant difference (P = 0.006649). 12 cases of dysplasia were observed in the 34 HIV+ women and distributed as follows: 0% of mild dysplasia, 18.92% of How to cite this paper: moderate dysplasia and 13.51% of severe dysplasia. In HIV− women we detected 6 cases of dysplasia including 1.35% of mild dysplasia, 4.05% of moderate dysplasia and 2.70% of severe dysplasia. Regarding HPV infection, we observed 21 cases of HPV among 34 HIV+ women (61.76%) against 23 cases in HIV− women (31.08%); we did not detect any cases of HSV. Conclusion: The prevalence of precancerous lesions remains high in HIV+ women, hence the need to include routine screening for precancerous lesions in all HIV+ women at all ages, as well as the routine search for HPV excretion in all those with cellular dysplasia.

HPV/HBV or HPV/HCV Co-Infections in Women Treated for Chronic Hepatitis at H&#244;pital Saint Camille in Ouagadougou, Burkina Faso

“…They were infected with both high-risk and low-risk HPV. HIV has already been documented as a risk factor for HPV infection and persis-tence, and for multiple HPV types, even when treated with ART [29] [30] [31]. Two studies in Burkina Faso found prevalences of 58.33% and 59.5% respectively of HPV infection in HIV-positive women [20] [22].…”

“…Endocervical samples were tested for HPV genotypes by Polymerase Chain Reaction (PCR)/hybridization using the HPV Direct Flow Chip kit (Vitro Master Diagnóstica). This method, based on PCR followed by hybridization, identi-fied 36 HPV genotypes, including 18 high-risk genotypes (HR-HPV) such as HPV 16,18,26,31,33,35,39,45,51,52,53,56,58,59, 66, 68, 73 and 82, and 18 low-risk genotypes (LR-HPV), namely HPV 6,11,40,42,43,44,54,55,61,62,67,69,70,71,72,81, 84 and 89. Samples were pretreated twice with DNAse/ RNAse free solution and 30 μL of each sample was then added to the PCR mix.…”