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2022-RA-991-ESGO Assessment of high-risk human papillomavirus infections and cervical dysplasia in human immunodeficiency virus-positive pregnant women in germany: a prospective cross-sectional two-center study
  1. Charlotte Kalinka Sophie Metz1,
  2. Anna Sophie Skof2,
  3. Jalid Sehouli3,
  4. Jan-Peter Siedentopf1,
  5. Fabian Weiß4,
  6. Irene Alba-Alejandre4,
  7. Katharina von Weizsäcker1,
  8. Wolfgang Henrich1,
  9. Andreas M Kaufmann2 and
  10. Irena Rohr1
  1. 1Department of Obstetrics, Charité – Universitätsmedizin Berlin, Berlin, Germany
  2. 2Laboratory for Gynaecological Tumor Immunology, HPV Laboratory, Charité – Universitätsmedizin Berlin, Berlin, Germany
  3. 3Department of Gynaecology, Charité – Universitätsmedizin Berlin, Berlin, Germany
  4. 4Clinic and und Policlinic for Gynaecology and Obstetrics, Ludwig-Maximillian Universität, Munich, Germany


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.

Abstract 2022-RA-991-ESGO Figure 1

Prevelence of HR-HPV genotypes in pregnant WLWH

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.

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