Oncogenic HPV among HIV infected female population in West Bengal, India

Abstract

BackgroundPrevalence of both cervical cancer and Human Immunodeficiency Virus (HIV) infection are very high in India. Natural history of Human Papilloma Virus (HPV) infection is known to be altered in HIV positive women and there is an increased possibility of persistence of HPV infections in this population. Therefore, this study was conducted to understand the epidemiology and circulating genotypes of oncogenic HPV among HIV positive and negative female population in West Bengal, India.MethodsIn this hospital-based cross-sectional study, 93 known HIV positive females attending a pre-ART registration clinic and 1106 HIV negative females attending a Reproductive and Child Health Care Clinic were subjected to study. Cervical cell samples collected from the study population were tested for the presence of HPV 16, 18 using specific primers. Roche PCR assay was used to detect other specific HPV genotypes in the cervical cells specimens of HIV positive cases only.ResultsPrevalence of HPV 16, 18 among HIV positive females (32.2%; n = 30) was higher than HIV negative females (9.1%; n = 101). About 53% (23/43) of cases with oncogenic HPV were infected with genotypes other than 16, 18 either as single/multiple infections. HPV 18 and HPV 16 were the predominant genotypes among HIV positive and HIV negative subjects respectively. Oncogenic HPV was not found to be associated with age and duration of sexual exposure. But the presence of HIV was found to a statistically significant predictor oncogenic HPV.ConclusionThe currently available HPV vaccines offer protection only against HPV 16 and 18 and some cross- protection to few associated genotypes. These vaccines are therefore less likely to offer protection against cervical cancer in HIV positive women a high percentage of who were infected with non-16 and non-18 oncogenic HPV genotypes. Additionally, there is a lack of sufficient evidence of immunogenicity in HIV infected individuals. Therefore, prevention of cervical cancer in HIV positive women must be focused towards early detection of oncogenic HPV & cervical cytological abnormality followed by an appropriate treatment.

Cervical cytological abnormalities and human papilloma virus infection in women infected with HIV in Southern India

“…In our study, the prevalence of HPV infection among HIV‐infected women was 57.7%. Studies done in India have found a varying prevalence of 26.4% to 56% . High‐risk HPV types are reportedly found in 37.3–59% of patients with HIV .…”

Genotypic Distribution of Different Variants of Oncogenic Human Papilloma Virus (HPV) among the Sexually Active HIV-1 Positive Female Population from Manipur, India

“…A recent study from Eastern India [16] has also shown prevalence of HPV 16, 18 among HIV positive females from Kolkata (32.2%; n = 30) was higher than HIV negative females (9.1%; n = 101). About 53% (23/43) of cases with oncogenic HPV were infected with genotypes other than 16, 18 either as single/multiple infections.…”

“…Both vaccines have demonstrated high efficacy against precancerous lesions caused by 16/18 types of HPV. Gardasil, a quadrivalent human papillomavirus vaccine is designed based on HPV types 6,11,16,18. Cervarix is based on HPV types 16 and 18.…”

A study on HPV mRNA test and colposcopy in HIV positive women for early detection of cervical intraepithelial lesions

“…10 Similar study by Sarkar et al (2011), risk becomes higher when age was more than 30. 4 According to present study lower genital tract infections were more prevalent in age group between 31-39 years. Probably this was related with declining body immunity as seen in more advanced HIV infected cases.…”

“…A hospital based study from the eastern part of India observed a prevalence of oncogenic HPV among HIV-positive women to be 46.2% whereas a study from northern India showed a prevalence of high-risk HPV in 20%. 4,5 Justification HIV positive women are at higher risk of developing reproductive tract infections as compared to HIV negative women. Large observational studies involving HIV positive women have demonstrated a strong and consistent association between confection with HIV, HPV and CIN.…”