Human Papillomavirus Infection Among HIV-positive Women in Lubumbashi, Democratic Republic of the Congo

Abstract

Background: Human Papillomavirus (HPV) infection is the most common sexually transmitted infection in the world, particularly affecting people living with human immunodeficiency virus (HIV). A synergy between the two viruses is however described by several authors but very little is known in women living with HIV-HPV co-infection in Lubumbashi in the South of the Democratic Republic of Congo (DRC). Objective: The purpose of this study was to determine the prevalence of HPV infection in women living with HIV, to define the socio-demographic profile of HPV infection and to analyze certain clinical and paraclinical parameters. Methodology: A total of 77 women, including 58 HIV-infected women (group 1) and 19 HIV-free women (group 2), were included in a cross-sectional descriptive study that was conducted from November 01 to 30, 2019 at the HIV-AIDS Mother-Child Transmission Prevention Unit (MCTPU) of the Lubumbashi University Clinics (LUC). HPV was tested on cervical-vaginal secretions obtained either by self-sampling or by a sample taken by a previously trained examiner. HPV was investigated by the INNO-LIPA (PCR) method at the Microbiology, Bioorganic Chemistry and Macromolecular Unit laboratory of the Free University of Brussels in Belgium (FUB) while the diagnosis of HIV infection (PCR), viral load determination and CD4 level assay was performed in the LUC laboratory. Results: The overall frequency of HPV infection was 74.03%. It was significantly higher in HIV-infected women than in non-HIV-infected women (81.08% vs. 52.63%). The socio-demographic profile of the HPV-infected patient was made up of predominantly married, multi-parented women, aged on average 35, with a secondary education level and an average socio-economic level. Low monthly incomes and HIV infection were almost 4 times at risk for HPV infection (OR 4.2 [1,439-12,262] and OR 3.75 [1,269-11,080] respectively). Finally, HIV-positive patients infected with HPV had overall low levels of Lymphocyte T CD4 compared to those not infected with HPV. Conclusion: Our study shows that in Lubumbashi, HPV infection is present in both HIV-positive and negative women but its prevalence is distinctly higher in HIV-positive patients than those without HIV infection. It is interesting to determine in subsequent studies the different genotypes of HPV circulating in Lubumbashi and to define the proportion of genotypes at high carcinogenic risk.