Influence of HIV-1 and/or HIV-2 infection and CD4 count on cervical HPV DNA detection in women from Senegal, West Africa

Abstract

Background HIV infection is associated with greater risk of precancerous lesions and cervical cancer in women. However, several factors remain unclarified regarding the association between HIV infection and HPV detection, especially among those with HIV type 2 versus type 1 infection and severely immunocompromised persons. Objectives To evaluate HPV overall and type-specific detection among HIV-infected and uninfected women in Senegal. Study Design Detection of HPV DNA for 38 genotypes in cervical swabs using PCR-based methods was evaluated in HIV-positive (n=467) and HIV-negative (n=2139) women participating in studies in Senegal. Among HIV-1 and/or HIV-2 positive women, CD4 counts were assessed. Adjusted multivariable prevalence ratios (PR) were calculated. Results The prevalence of any HPV DNA and multiple HPV types was greater among HIV-infected individuals (78.2% and 62.3%, respectively) compared with HIV-negative women (27.1% and 11.6%). This trend was also seen for HPV types 16 and 18 (13.1% and 10.9%) compared to HIV-negative women (2.2% and 1.7%). HIV-infected women with CD4 cell counts less than 200 cells/µl had a higher likelihood of any HPV detection (PRa 1.30; 95% CI 1.07–1.59), multiple HPV types (PRa 1.52; 95% CI 1.14–2.01), and HPV-16 (PRa 9.00; 95% CI 1.66–48.67), but not HPV-18 (PRa 1.20, 95% CI 0.45–3.24) compared to those with CD4 counts 500 cells/µl or above. Conclusion HIV-infected women, especially those most severely immunocompromised, are more likely to harbor HPV. Measures to prevent initial HPV infection and subsequent development of cervical cancer through focused screening efforts should be implemented in these high risk populations.

Screening for human papillomavirus, cervical cytological abnormalities and associated risk factors in HIV‐positive and HIV‐negative women in Rwanda

“…The percentage of HIV‐positive patients on ART has increased significantly in recent years, and in 2015 the percentage was 79% . HIV‐positive women on ART and with a normal CD4 count had a decreased risk of being infected with HPV and being diagnosed with SILs, which is consistent with previous studies . Still, the prevalence of HPV was higher in the group of well‐treated HIV‐positive women compared with the HIV‐negative women.…”

Age-specific prevalence of human papilloma virus infection among Nigerian women

“…The results of some studies suggests that HIV infection is a known risk factor for HPV infection [27]. In our study, we found an association between HIV and HPV infection and this association remained statistically significant when we examined the association between HIV and different categories of HPV.…”

Prevalence of human papillomavirus by geographical regions, sexual orientation and HIV status in China: a systematic review and meta-analysis

“…In the Chinese setting, we recommend three actionable measures. First, early initiation of antiretroviral therapy for HIV and improvement of treatment adherence will be effective in reversing the depletion of CD4 T cells, and decrease the likelihood of HPV infection and prevent HPV-related anal and cervical cancers in the long term 58. Second, HPV vaccination has already been shown to be immunogenic and cost-effective in women,59 60 PLHIV and MSM61–63 in many countries.…”