The epidemiology of human papillomavirus infection in HIV-positive and HIV-negative high-risk women in Kigali, Rwanda

Veldhuijzen, Nienke J.; Braunstein, Sarah L.; Vyankandondera, Joseph; Ingabire, Chantal Marie; Ntirushwa, Justin; Kestelyn, Evelyne; Tuijn, Coosje J.; Wit, Ferdinand W. N. M.; Umutoni, Aline; Uwineza, Mireille; Crucitti, Tania; Wijgert, Janneke van de

doi:10.1186/1471-2334-11-333

Cited by 48 publications

(59 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The current study demonstrated the high HPV/HIV co-infection of 24.4%, with high hr-HPV prevalence across almost all age groups and more multiple hr-HPV infection in HIV-positive women than compared to HIV-negative women. These findings are consistent with previous studies reporting higher prevalence of HPV [9, 27, 30, 35] and higher frequency of infection with multiple HPV types among HIV infected women [30, 32, 36]. A number of risk factors for HPV infection among women have been demonstrated in previous studies, including having more than one partner, early sexual initiation, age and marital status.…”

Section: Discussionsupporting

confidence: 92%

Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

et al. 2017

View full text Add to dashboard Cite

BackgroundHigh risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland.MethodsA total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays.ResultsThe overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0–15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, p<0.001). Overall hr-HPV/HIV co-infection was 24.4% (95%CI: 20.3–29.1) which was significantly higher among younger age groups (p<0.001). Prevalence of multiple group hr-HPV infection was significantly higher in HIV-positive versus -negative women (27.7% and 12.7% respectively, p<0.001). The presence, absence or unknown of history of STI with HIV did not appear to modify the relationship with hr-HPV (OR = 4.2, 95%CI: 2.6–7.1, OR = 4.6, 95%CI: 2.8–7.7, p<0.001, p<0.001 and OR = 4.1, 95%CI: 1.3–13.4, p<0.021 respectively).ConclusionThe prevalence of hr-HPV infection was high and significantly associated with HIV among sexually active women. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections which may explain the high prevalence among HIV infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV infected people.

show abstract

Section: Discussionsupporting

confidence: 92%

Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Moreover, among HIV-infected women in our sample, those with highest levels of immunosuppression (CD4 < 200 cells/µl) were most likely to have any, multiple, and high-risk types of HPV detected. This finding is consistent with most, although not all, of other studies evaluating this association 10,18,22–25 .…”

Section: Discussionsupporting

confidence: 92%

“…It is hypothesized that HIV-induced immunosuppression, through the lowering of CD4 T-cells, may increase the risk of HPV detection, HPV persistence, and subsequent development of cervical neoplasia 18–21 . Limited data exist to confirm the relationship between measurement of CD4 count and HPV detection, however, and the information that does exist has not been entirely corroborative 10,18,22–25 . In addition, little is known concerning the effect of CD4 count on HPV type-specific detection, including the most commonly-detected oncogenic types, HPV-16 and HPV-18.…”

Section: Introductionmentioning

confidence: 99%

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

Hanisch¹,

Sow²,

Toure³

et al. 2013

Journal of Clinical Virology

View full text Add to dashboard Cite

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.

show abstract

“…Outros estudos encontraram resultados que variaram de 72,2 a 90,2% e de 23,8 a 54,6%, respectivamente, para as positivas e negativas para o HIV 11,34,35 , enquanto um estudo brasileiro encontrou resultados de 73,2 e 23,8% 30 , respectivamente, para as positivas e negativas para o HIV.…”

Section: Métodosunclassified

Prevalência de infecção cervical por papilomavírus humano e neoplasia intraepitelial cervical em mulheres HIV-positivas e negativas

Ceccato¹,

Lopes²,

Nascimento³

et al. 2015

Rev. Bras. Ginecol. Obstet.

View full text Add to dashboard Cite

Resumo OBJETIVO: Realizar estudo comparativo entre mulheres positivas e negativas para o vírus da imunodeficiência humana (HIV), analisando: prevalência de neoplasia intraepitelial cervical (NIC) e infecção cervical pelo papilomavírus humano (HPV); risco viral e relação com desenvolvimento de NIC; parâmetros sociodemográficos e de comportamento que influenciaram na presença de infecção cervical por HPV e NIC. MÉTODOS: Estudo comparativo entre mulheres positivas e negativas para o HIV, sendo analisadas, respectivamente, 202 e 171 mulheres para avaliar a prevalência de NIC e 164 e 100 mulheres para avaliar a prevalência de infecção cervical pelo HPV. Em todas as consultas foram realizados: coleta de amostras cervicais para realização de citologia oncótica e reação em cadeia da polimerase (PCR) para detecção do DNA-HPV; colposcopia; questionário padronizado para coleta de dados demográficos/comportamentais; biópsia de todas as alterações colposcópicas. O exame histopatológico foi o padrão-ouro para o diagnóstico de NIC. RESULTADOS: A prevalência de NIC foi de 2,4 e 15,3% (p<0,001) e de infecção cervical pelo HPV foi de 37,1 e 55,5% (p=0,002), respectivamente, nas negativas e positivas para o HIV. As soropositivas tiveram mais infecção por HPV de alto risco (35,7 e 23,6%; p=0,02) e por múltiplos tipos (6,2 e 0%). O HPV 16 foi o tipo prevalente, ocorrendo em 11,3 e 10,2% das positivas e negativas para o HIV e também nas mulheres que tiveram NIC nos dois grupos. Os fatores associados ao desenvolvimento de NIC foram: infecção pelo HIV (HT=4,64; IC95% 2,23-9,65), idade (HT=0,95; IC95% 0,93-0,98 para cada ano de vida) e estado civil (HT=0,49; IC95% 0,30-0,80). Os fatores associados à infecção pelo HPV foram: presença do HIV (HT=2,72; IC95% 1,77-4,17), maior número de parceiros sexuais (HT=1,87; IC95% 1,23-2,84), idade (HT=0,97; IC95% 0,95-0,99 para cada ano de vida) e estado civil (HT=0,65: IC95% 0,42-1,0 para união estável/viúvas). CONCLUSÃO: A prevalência de NIC e infecção cervical pelo HPV foi maior nas mulheres positivas para o HIV, que também apresentaram mais infecções por HPV de alto risco e múltiplos tipos. O tipo 16 foi o predominante nos dois grupos e nas mulheres que tiveram NIC. As mulheres com mais idade e união estável/viúvas tiveram menor chance de adquirir infecção cervical por HPV e NIC. AbstractPURPOSE: To conduct a comparative study between two groups of women (HIV positive and negative) analyzing: the prevalence of cervical intraepithelial neoplasia (CIN) and cervical HPV infection; viral risk and relationship with development of CIN; and sociodemographic and behavioral parameters that influence cervical HPV infection and the development of CIN. METHODS: A cross-sectional study in which 202 HIV-positive women and 164 HIV-negative women were analyzed to assess the prevalence of CIN and 171 HIV-positive women and 160 HIV-negative women were analyzed to assess the prevalence of cervical HPV infection. The following procedures were performed on the occasion of each medical visit: collection of cervical sa...

show abstract

The epidemiology of human papillomavirus infection in HIV-positive and HIV-negative high-risk women in Kigali, Rwanda

Cited by 48 publications

References 35 publications

Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

Prevalence of and Associated Risk Factors for High Risk Human Papillomavirus among Sexually Active Women, Swaziland

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

Prevalência de infecção cervical por papilomavírus humano e neoplasia intraepitelial cervical em mulheres HIV-positivas e negativas

Contact Info

Product

Resources

About