Prevalence of high risk HPV in HIV+ and HIV- women with cervical dysplasia at the Moi Teaching and Referral Hospital

Abstract

Background: Cervical cancer, caused by Human Papillomavirus, is the second commonest cancer among women. HIV+ women are at a higher risk of acquiring HPV, developing pre-cervical cancer lesions (dysplasia) and cervical cancer. Early diagnosis is key to prevention of cervical cancer but reduced sensitivities and specificities of available screening methods pose challenges. The role of HPV in VIA related dysplasia has not been extensively interrogated. We sought to understand HPV infection in the context of HIV status and its relationship to VIA dysplasia

Objectives: To compare prevalence of high risk HPV in HIV positive and HIV negative women with and without cervical dysplasia.

Study Design: A cross sectional study design.

Setting: AMPATH/MTRH cervical cancer and prevention program clinic located at the Moi Teaching and Referral Hospital provides cervical cancer screening services for women.

Participants: Women attending cervical cancer screening clinics

Results: A total of 88 women were enrolled into the study. HR HPV prevalence was 59.1% among HIV+ and 43.2% among HIV- women. Women below 25 years had higher HRHPV prevalence. HPV prevalence was higher in women with higher parity. Higher HRHPV prevalence in younger women attributed to early sexual debut. The higher prevalence of HRHPV in HIV+ women was as a consequence of depressed immunity and greater exposure to risk factors

Conclusion: HIV+ women are more infected with HRHPV than their HIV- counterparts. Immune system related factors which affect the interpretation of screening tests like VIA require further investigation especially in immune compromised individuals.