HUMAN PAPILLOMAVIRUS INFECTION IN HUMAN IMMUNODEFICIENCY VIRUS POSITIVE WOMEN UNDER ROUTINE PAP SMEAR

The present study aimed to investigate HPV prevalence associated with cervical  cytology and to evaluate data from 140 HIV positive women routinely attended at an out-patient public gynecological service in Rio de Janeiro state. The CD4 cell counts and HIV-1 RNA levels were determined using standardized protocols. HPV status and HPV 16 detection were ascertained respectively by My09/11 consensus primers and type specific primers. Colpocytology was performed at the first or subsequent visit to the service. Among women, 98.6% of them were under antiviral treatment, 92.1% had over 200 CD4 cells/mm3, 62.9% had detectable HIV RNA, 60.7% were HPV infected and 21.2 % harbored the HPV type 16. Normal/inflammatory results were prevalent (57.1%) and 7.9% of the patients had HSIL. Studying demographic data and HIV markers that could affect HPV infection, we found that time elapsed since positive diagnosis of less than four years was a significant factor. First sexual intercourse beginning earlier than 17 years, people younger than 30 years and white ethnicity were also linked to HPV infection. Alcohol use was marginally related to HPV prevalence. Patients with severe immune depression were strongly predisposed to HPV infection (from 90.9% of patients carrying less than 200 cells/mm3 to 45.5% in those with CD4 cell level above 500 cells/mm3) and the development of cervical lesions. There was no relation between HIV immune status and HPV type 16, but HIV seropositive women with abnormal cytology were three times more likely to harbor this HPV type. The high HPV prevalence as opposed to absence of cancer cases was probably due to the moderate immune status of the women studied added to routine cancer prevention exams. DOI: http://dx.doi.org/10.17525/vrrjournal.v13i1-2.15