DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193791

Prevalence of abnormal cervical cytology and HPV DNA positivity among HIV positive women

Sunita Malik, Supriti Kumari, Harsha S. Gaikwad, Archana Mishra, Mausumi Bharadwaj

Abstract


Background: The relationship among HIV, HPV, and development of CIN is complex and incompletely understood. Present study is undertaken to find out the prevalence and relationship of abnormal cervical cytology and HPV infection in HIV positive women.

Methods: This was a cross-sectional, case control study conducted on 95 HIV seropositive and 95 seronegative women. Specimen was collected from the cervix for HPV DNA testing, subtyping and cytology.

Results: HPV DNA positivity was higher in seropositive group (18.6% vs. 7.4%). Premalignant conditions were found only in seropositive group. At CD4 count <249 HPV DNA positivity was 53%, at 250-499 the percentage of HPV DNA positivity was 31% and at >500 HPV DNA positivity was 19%.

Conclusions: Prevalence of abnormal cytology and HPV DNA positivity is higher amongst HIV positive women and there is an association between HPV DNA positivity with lower CD4 counts.

 


Keywords


Abnormal cytology, Cervix, HIV, HPV infection

Full Text:

PDF

References


Guillarmod MJ, Pasquier J, Greub G, Bongiovanni M, Achtari C, Sahli R, Impact of HPV vaccination with Gardasil® in Switzerland. BMC Infect Dis. 2017;17:790.

Verma M, Erwin S, Abedi V, Hontecillas R, Hoops S, Leber A. Modeling the mechanisms by which HIV-associated immune suppression influences HPV persistence at the oral mucosa. PLoS One. 2017;12(1):e0168133.

Looker KJ, Rönn MM, Brock PM, Brisson M, Drolet M, Mayaud P, et al. Evidence of synergistic relationships between HIV and Human Papillomavirus (HPV): systematic reviews and meta‐analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status. J Int AIDS Soc. 2018;21(6):e25110.

Denny LA, Franceschi S, de Sanjosé S, Heard I, Moscicki AB, Palefsky J. Human papillomavirus, human immunodeficiency virus and immunosuppression. Vaccine. 2012;30 Suppl 5:F168-74.

Menon S, Rossi R, Zdraveska N, Kariisa M, Acharya SD, Vanden Broeck D, et al. Associations between highly active antiretroviral therapy and the presence of HPV, premalignant and malignant cervical lesions in sub- Saharan Africa, a systematic review: current evidence and directions for future research. BMJ Open. 2017;7(8):e015123.

Camargo M, Leon SC, Munoz M, Sanchez R, Herrera DP. Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia. BMC Cancer. 2014;14:451.

Chakravarty J, Chourasia A, Thakur M, Singh AK, Sunder S, Agrawal NR. Prevalence of human papillomavirus infection and cervical abnormalities in HIV-positive women in eastern India. Indian J Med Res. 2016;143(1):79-86.

Massad LS, Xie X, D’Souza G. Incidence of cervical precancers among HIV-seropositive women. Am J Obstet Gynecol. 2015;212:606.e1-8.

Hanisch RA, Sow PS, Toure M, Dem A, Dembele B, Toure P, et al. For the University of Washington-Dakar HIV and Cervical Cancer Study Group Influence of HIV-1 and/or HIV-2 infection and CD4 count on cervical HPV DNA detection in women from Senegal, West Africa. J Clin Virol. 2013;58(4):696-702.

Madan A, Patil S, Nakates L. A Study of Pap Smear in HIV-Positive Females. The J Obstet Gynecol India. 2016;66(6):453-9.

Kelly H, Weiss AH, Benavente Y, Sanjose SD, Mayaud P. ART and HPV Review Group, Association of antiretroviral therapy with high-risk human papillomavirus, cervical intraepithelial neoplasia, and invasive cervical cancer in women living with HIV: a systematic review and meta-analysis Lancet HIV. 2018;5(1):e45-e58.

Clifford GM, Franceschi S, Keiser O. Immunodeficiency and the risk of cervical intraepithelial neoplasia 2/3 and cervical cancer: A nested case-control study in the Swiss HIV cohort study. Int J Cancer. 2016;138:1732-40.