Risk factors for cervical HPV infection and genotypes distribution in HIV-infected South Brazilian women

Abstract

BackgroundHuman Papillomavirus (HPV) infection is particularly burdensome for women infected with human immunodeficiency virus (HIV), which increases their risk of developing cervical lesions and cancer (CC). We conducted a molecular study of the distribution of cervical HPV genotypes and the risk factors for this infection in HIV-infected Brazilian women.FindingsCervical and endocervical samples for Papanicolaou screening and HPV detection were collected from 178 HIV-infected women using highly active antiretroviral therapy (HAART) of Maringá city/Brazil. Risk factors were assessed using a standardized questionnaire, and the data regarding to HIV infection from medical records. HPV was detected by polymerase chain reaction (PCR), and genotyping using PCR-restriction fragment length polymorphism analysis. HIV infection was well controlled, but women with a current CD4+ T lymphocyte count between 200–350 cells/mm3 (37.6%) had a two-fold greater risk of HPV infection than those with > 350 cells/mm3 (26.4%). HPV was associated with parity ≥3, hormonal contraceptive use and current smoker. HPV infection occurred with high frequency (46.6%) but a low frequency of cervical abnormalities was detected (7.30%), mainly low-grade squamous intraephitelial cervical lesions (LSIL) (84.6%). A high frequency of multiple HPV infections was detected (23.0%), and the most frequent HPV genotype was HPV-72 (6.7%), followed by −16, -31 and -51 (6.14% each).ConclusionsWe showed that HAART use does not protect HIV-infected women from HPV, but appear to exert some protection against cervical lesions development. This study provides other important information about risk factors and cervical HPV in HIV-infected women, which can contribute to planning protocols.

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

“…It is possible that these findings are due to the great majority of studies being performed in the Southern and Southeast of Brazil, as these regions are the most developed compared to others. In these regions, HIV+ women are has better follow-up statistics and correctly use the HAART, which seems to protect against the development of cervical lesions (Rocha-Brischiliari et al, 2014). The prevalence of low-grade cervical abnormalities is common in younger patients (Kurman et al, 2011), which is in agreement with these studies once the median age of HIV+ and HIV-women was below 35 years old (Entiauspe et al, 2010;Oliveira et al, 2010;Andrade et al, 2011;Melgaco et al, 2011;.…”

“…Instead, in 2011, a descriptive cross-sectional study by Fedrizzi et al showed a higher prevalence of HPV in HIV+ women with or without HAART in comparison to HIV-women (70.0% and 21.2%, respectively), but the frequency of HR-HPV was similar (71.4%) among the two groups. A study conducted by Rocha-Brischiliari et al (2014) evaluated a population of HIV+ women who were using HAART. In addition to the high prevalence of HPV (46.6%) detected, a high proportion of HPV coinfections was found (two or more genotypes in the same women) (23.0%).…”

“…A low prevalence of cervical abnormalities was found, and the most prevalent abnormal cytologies were ASC-US and/or LSIL (Melgaco et al, 2012;Rocha-Brischiliari et al, 2014).…”

Uncommon non-oncogenic HPV genotypes, TP53 and MDM2 genes polymorphisms in HIV-infected women in Southern Brazil

“…4 Cervical intraepithelial neoplasia (CIN) development and cervical cancer in HPV-infected women are associated with risk factors, such as young age, high number of sexual partners throughout life, early sexual debut, smoking, genetics variants, among others. 5,6 Moreover, co-infections, such as those with Human Immunodeficiency Virus (HIV) and Chlamydia trachomatis bacterium, may be involved as co-factors to CC development, acting as adjuvants of the neoplastic process. 7,8 The polymorphism on codon 72 (Arg72Pro) of TP53 tumor suppressor gene has been extensively investigated regarding association with a wide range of cancers worldwide.…”

Pap smear analysis of HIV Positive Rural Females of West Godavari District of Andhra Pradesh India

“…Moodley et al 6 in 2004 at Western Cape Town found 23% total SIL with 14% LSIL and 9% HSIL in HIV positive cases while in HIV negative total SIL was 6% with 3% each SIL and HSIL. Rocha-Brischiliari SC et al 7 in 2014 at Brazilian HIV infected females found high frequency of HPV infection (46.6%) but with a low frequency of cervical abnormalities (7.30%), mainly low-grade squamous intraephitelial cervical lesions (LSIL) (84.6%). A high frequency of multiple HPV infections was also detected (23.0%).…”