HIV/HPV co-infection during pregnancy in southeastern Brazil: Prevalence, HPV types, cytological abnormalities and risk factors

Meyrelles, Ângela R.; Siqueira, Juliana D.; Hofer, Cristina Barroso; Costa, Tomaz Pinheiro da; Azevedo, Andréa Paula de; Guimarães, Bruna V.; Seuánez, Héctor N.; Soares, Marcelo A.; Almeida, Gutemberg; Soares, Esmeralda A.; Machado, Elizabeth S.

doi:10.1016/j.ygyno.2012.10.003

Cited by 24 publications

(26 citation statements)

References 33 publications

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“…According to Winer and colleagues, the actual first peak of HPV infection might be before the age of 25 years, as women are usually infected after sexual initiation [29]. HPV16 and 18 types have been found to be the most prevalent high risk types in most studies [4, 26–28, 30–32], yet in the current study we were not able to establish that. However, we observed high frequency of hr-HPV31/33/35/52/58 group types among the study population.…”

Section: Discussioncontrasting

confidence: 66%

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

et al. 2017

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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.

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Section: Discussioncontrasting

confidence: 66%

“…In China the prevalence of HPV infection was found to vary between regions from 13.8%–44.4% [28]. A higher prevalence of above 75% was observed in two studies conducted in Brazil [22, 26]. Furthermore, the prevalence found in this study is higher than that of the sub-Saharan Africa region (SSA) (24.0%) [10].…”

Section: Discussionmentioning

confidence: 64%

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

et al. 2017

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“…Only high‐grade CIN is more likely to persist after delivery, and the present prevalence of HGSILs in postpartum women (0.7%) is higher than that in most other reported studies of pregnant women (0.4%) . A large population‐based study in Brazil confirmed that the prevalence of HGSILs (0.4%) in pregnant women was similar to that in their nonpregnant counterparts. There are few studies that have investigated the association between CIN and HIV in pregnancy, but most studies did not compare their findings with an HIV‐uninfected group of pregnant women .…”

Section: Discussionsupporting

confidence: 54%

“…A large population‐based study in Brazil confirmed that the prevalence of HGSILs (0.4%) in pregnant women was similar to that in their nonpregnant counterparts. There are few studies that have investigated the association between CIN and HIV in pregnancy, but most studies did not compare their findings with an HIV‐uninfected group of pregnant women . In the present study, when compared with women with a normal Pap smear, the prevalence of HIV infection was twofold higher in women with LGSILs and almost 2.5 times higher among women with HGSILs after delivery.…”

Section: Discussionmentioning

confidence: 78%

Prevalence, risk factors, and pregnancy outcomes of cervical cell abnormalities in the puerperium in a hyperendemic HIV setting

Maise

Moodley

Sebitloane

et al. 2017

Intl J Gynecology & Obste

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Objective: To investigate the impact of cervical cell abnormalities detected in the puerperium in association with HIV-1 infection on pregnancy outcomes. Methods:The present study was a secondary data analysis of pregnancy outcomes, Conclusion:Pregnant women with HIV were more likely to be diagnosed with higher grades of squamous cell abnormalities than those without HIV. There was no association between squamous cell abnormalities/HIV comorbidity and adverse pregnancy outcomes.

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“…In the Southeast region, Meyrelles et al (2013) showed HPV-DNA in 84.3% of HIV+ pregnant women, with 28 different genotypes. The HR-HPV genotypes were detected in the majority of cases (79.8% versus 20.2% of LR-HPV), and HPV co-infections occurred in 16.3% of cases.…”

Section: Prevalence Of Hpv and Cervical Abnormalities In Hiv+ Brazilimentioning

confidence: 99%

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

Freitas

Suehiro²,

Consolaro³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Human papillomavirus is a virus that is distributed worldwide, and persistent infection with high-risk genotypes (HR-HPV) is considered the most important factor for the development of squamous cell cervical carcinoma (SCC). However, by itself, it is not sufficient, and other factors may contribute to the onset and progression of lesions. For example, infection with other sexually transmitted diseases such as human immunodeficiency virus (HIV) may be a factor. Previous studies have shown the relationship between HPV infection and SCC development among HIV-infected women in many regions of the world, with great emphasis on low-and middleincome countries (LMICs). Brazil is considered a LMIC and has great disparities across different regions. The purpose of this review was to highlight the current knowledge about HPV infection and cervical abnormalities in HIV+ women in Brazil because this country is an ideal setting to evaluate HIV impact on SCC development and serves as model of LMICs and low-resource settings.

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HIV/HPV co-infection during pregnancy in southeastern Brazil: Prevalence, HPV types, cytological abnormalities and risk factors

Cited by 24 publications

References 33 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

Prevalence, risk factors, and pregnancy outcomes of cervical cell abnormalities in the puerperium in a hyperendemic HIV setting

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

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