Prevalence and Associated Factors of High-Risk Human Papillomavirus Infections among Human Immunodeficiency Virus-Infected Women in Lagos, Nigeria

Abstract

Background: Given the synergistic relationship between human immunodeficiency virus (HIV) and human papillomavirus (HPV) infections, knowledge of the genotypic prevalence and associated factors of high-risk HPV (HR-HPV) among HIV-infected women is crucial for developing targeted interventions such as appropriate screening tests and effective genotype-specific vaccination. Objectives: We determined the prevalence of any HR-HPV and multiple HR-HPV infections and identified associated factors among a cohort of women living with HIV infections (WLHIV) in Lagos, Nigeria. Methods: This descriptive cross-sectional study analysed the data of 516 WLHIV who underwent cervical cancer screening as part of the COMPASS-DUST study at the HIV treatment centre of Lagos University Teaching Hospital from July 2023 to March 2024. Multivariable binary logistic regression models were performed to explore factors associated with HR-HPV and multiple HR-HPV infections. Results: Among the 516 WLHIV enrolled (mean age, 46.5±7.3 years), the overall HR-HPV prevalence was 13.4% (95% CI, 10.6–16.6), disaggregated as 3.3% for HPV16/18 (95% CI, 1.9–5.2) and 11.6% for other HR-HPV genotypes (95% CI, 9.0–14.7). Nineteen women (3.7%; 95% CI, 2.2–5.7)had multiple HR-HPV genotype infections. Having a recent serum CD4+ cell count ≤560 cells/µL (adjusted OR 3.32; 95% CI 1.06–10.38) and HPV 16/18 genotype infections (adjusted OR 38.98; 95% CI 11.93–127.37) were independently associated with an increased risk of multiple HR-HPV infections. Conclusion: The findings of this study provide valuable insights into the epidemiology of HR-HPV infections and highlight the need for tailored interventions and continuous monitoring. By addressing these challenges through targeted screening, effective ART management, and vaccination programs, we can improve health outcomes and reduce the burden of cervical cancer in this vulnerable population.