Prevalence and Risk Factors of Infection with High Risk Human Papilloma Viruses among HIV-Positive Women with Clinical Manifestations of Tuberculosis in a Middle-Income Country

Abstract

Women living with HIV-1 are at high risk of infection with human papillomavirus of high carcinogenic risk (HR HPVs). M. tuberculosis (TB) promotes HPV infection and increases the risk to develop HPV-associated cancer. Our knowledge of persisting HR HPVs genotypes, and of the factors promoting HR HPV infection in people living with HIV-1 with clinical TB manifestations is sparse. Here, we analyzed 58 women living with HIV-1 with clinical TB manifestations (WLWH with TB) followed up in specialized centers in Russia, a middle income country endemic for HIV-1 and TB, for the presence in cervical smears of DNA of twelve HR HPV genotypes. DNA encoding HPV16 E5, E6/E7 was sequenced. Sociodemographic data of patients was collected by questionnaire. All women were at C2-C3 stages of HIV-infection (by CDC). The majority were over 30 years old, had secondary education, were unemployed, had sexual partners, experienced 2–3 pregnancies and at least one abortion, and were smokers. The most prevalent was HPV16 detected in the cervical smears of 38% of study participants. Altogether 34.5% of study participants were positive for HR HPV types other than HPV16; however, but none of these types was seen in more than 7% of tested samples. Altogether, 20.7% of study participants were positive for several HR HPV types. Infections with HPVs other than HPV16 were common among WLWH with generalized TB receiving combined ART/TB-therapy, and associated with their ability to work, indirectly reflecting both their health and lifestyle. The overall prevalence of HR HPVs was associated with sexual activity of women reflected by the number of pregnancies, and of HPV 16, with young age; none was associated to CD4+-counts, route of HIV-infection, duration of life with HIV, forms of TB-infection, or duration of ART, characterizing the immune status. Thus, WLWH with TB—especially young—were predisposed to infection with HPV16, advancing it as a basis for a therapeutic HPV vaccine. Phylogenetic analysis of HPV16 E5, E6/E7 DNA revealed no common ancestry; sequences were similar to those of the European and American HPV16 strains, indicating that HPV vaccine for WLWH could be the same as HPV16 vaccines developed for the general population. Sociodemographic and health correlates of HR HPV prevalence in WLWH deserve further analysis to develop criteria/recommendations for prophylactic catch-up and therapeutic HPV vaccination of this highly susceptible and vulnerable population group.

Proceedings of the Online Conference “Vaccines and Vaccination during and Post COVID Pandemics” (7–9 December 2022)

“…The session was concluded with another study on HPV therapeutic vaccine research given by Dr. Juris Jansons (Latvian Biomedical Research and Study Center, and Riga Stradins University, Riga, Latvia), who presented results of DNA immunization of mice with HPV 16 E6 and E7. The study by Jansons et al evaluated the immunogenicity of the consensus HPV16 E6 and E7 designed after the analysis of HPV16 E6/7 sequences isolated from 35 HIV, TB or HIV/TB coinfected patients, which were found to be identical to the sequence of the reference HPV16 strain except for single amino acid substitutions [ 47 ]. Namely, 50% of the analyzed sequences of E6 contained substitutions of either R17G or L90V, or both.…”

Oncogenic Human Papillomavirus Infection (HPV 16/18) and Associated Factors among Women in East Gojjam Zone, Northwest Ethiopia 2021

“…Two (16 and 18) of the 150 HPV serotypes are oncogenic types. In the anogenital region, HPV infections can cause diseases such as condylomas or squamous cell carcinomas [1,2]. Often, our immunity can spontaneously clear off most HPV infections without treatment.…”

“…Furthermore, studies in Gurage Ethiopia also showed that the prevalence of HPV infection was 17.3%; which is a relatively high prevalence [8]. 2 Contrary to other malignancies of the reproductive system, cervical cancer can be avoided by early detection of a precancerous lesion through screening and treatment of lesions. Any one of the three techniques can be used to identify such lesions; human papillomavirus (HPV) Deoxyribose Nucleic Acid (DNA) test, pap smear, and visual inspection with acetic acid [9,10].…”