Introduction/Background Cervical dysplasia up to cervical carcinoma are in almost 100% associated with a high-risk HPV (HR-HPV) infection. The immunosuppressive influence of Human Immunodeficiency Virus (HIV) and the immunocompromised period of pregnancy are risk factors for acquisition and persistence of HR-HPV infections and their progression to precancerous lesions and HPV-associated carcinoma. There is still a lack of guideline-defined approaches, due to the lack of sufficient research, especially in Europe, for the screening and follow up of pregnant women living with HIV (WLWH) to prevent HPV-related cervical dysplasia.
Methodology HIV-positive pregnant women were included (n=81). HPV test and genotyping HPV test (multiplexed genotyping with BSGP5+/6+ PCR and Luminex read-out), cytology and colposcopy was done. A medical history questionnaire was used to record the clinical- and HIV data of the participants. Results are given in percentage. For continuous variables, mean or median was calculated. Categorical variables were compared by using chi2 test, whereas for continuous variables Mann-Whitney-U test was used. A p-value ≤ 0.05 was regarded statistically significant (CI 95%).
Results The HR-HPV prevalence in our study population was 45.7%. Multiple HPV infections were present in 27.2% of women, of whom all had at least one HR-HPV genotype included. HR-HPV16 and HR-HPV52 were the most common genotypes and were always present when high-grade squamous intraepithelial lesion (HSIL) was found (figure 1). Overall, 95.1% of study participants had an adequately treated HIV infection. HIV viral load < 50 copies/mL and a CD4 cell count ≥ 350 cells/µl correlated with a lower HR-HPV prevalence. In addition, a shorter HIV diagnosis time showed an increased prevalence of HR- and multiple HPV infections.
Conclusion HIV-positive pregnant women require particularly attentive and extended HPV screening, where clinical and HIV-related risk factors should always be taken into account.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.