High HPV genetic diversity in women infected with HIV-1 in Brazil

Abstract

The present study on genetic diversity of human papillomaviruses in women infected by HIV in Brazil describes the frequency, the genotypes, and five new variants of HPV. One hundred fifty cervical smears of HIV-positive women were subjected to cytological examination, and the DNA samples obtained were assayed by MY09/MY11 amplification, followed by RFLP typing. The overall HPV-DNA-positive rate was 42.7%. One hundred twenty-two samples (81.3%) had benign cellular alterations or normal cytological results, and HPV DNA frequency among them was 30.3%. Otherwise, 96.4% of samples with altered cytology were positive for HPV DNA. A high diversity of genotypes was observed. HPVs-16 and 81 were the most prevalent (14.1%) and were followed by HPVs 52, 35, 62, 33, 53, 56, 66, 70, 18, 58, 6b, 11, 31, 39, 40, 61, 71, 32, 54, 59, 67, 68, 85, and 102. Five new variants of the high-risk HPVs 18, 33, 53, 59, and 66 were detected. Possible associations between the detection of HPV genotypes and the cytological classification, HIV viral load, CD4 count, and antiretroviral treatment were also examined. We observed that a high proportion of HIV-infected women are infected with HPV and may carry oncogenic genotypes, even when cytological evaluation shows normal results.

New variants of human papillomavirus type 18 identified in central Brazil

“…In the present study we were able to characterize the LCR, E6, and L1 genomic regions of four HPV-18 Brazilian isolates: Bsb-27, Bsb-48, Bsb-82, and Bsb-206, which were identified in a previous study of HPV genetic diversity in HIVpositive women in central Brazil [17,18]. In central Brazil, we observed similar frequencies of HPV-18 infection, independent of HIV status: 4.5% among HIV-negative and 4.9% among HIV-positive women [18,28].…”

“…In the present study we were able to characterize the LCR, E6, and L1 genomic regions of four HPV-18 Brazilian isolates: Bsb-27, Bsb-48, Bsb-82, and Bsb-206, which were identified in a previous study of HPV genetic diversity in HIVpositive women in central Brazil [17,18]. In central Brazil, we observed similar frequencies of HPV-18 infection, independent of HIV status: 4.5% among HIV-negative and 4.9% among HIV-positive women [18,28]. Compared to HIV-negative women, HIV-positive women show a higher occurrence of multiple-type HPV infection, a decreased regression of low-grade lesions and a higher rate of progression from infection to cervical lesions and cancer, probably due to weakened response of the immune system [29,30].…”

“…The four HPV-18-positive samples, previously genotyped by Cerqueira et al [17,18], were isolated by cervical scraping from women co-infected with HIV-1. The presence of HPV DNA was assayed by PCR using MY09/ MY11 primers.…”

“…The objective of the present study was to characterize the LCR, E6, and L1 genetic variability of HPV-18 variants identified in our previous analysis of HPV genetic variability in cervicovaginal scrape specimens from women co-infected with HIV type 1 (HIV-1) in the Federal District, Central Brazil [17,18].…”

Cervical cancer prevention in settings of high HIV prevalence

“…Many of these women infected with HPV were found to carry oncogenic genotypes, even when cytological evaluation showed normal results. 15 Although HPV testing of cervical smears is more sensitive than cytological assessment, the specificity of HPV DNA testing may be unacceptably low in areas of high HIV prevalence. In one study, the specificity of HPV DNA testing for detection of high-grade squamous intraepithelial lesions (HSIL) was 75% in HIV-seronegative women and 41% in HIV-seropositive women.…”