High-risk human papillomavirus and cervical lesions among women living with HIV/AIDS in Brazilian Amazon, Brazil

• Published in: The Brazilian journal of infectious diseases Vol. 19; no. 6; pp. 557 - 562
• Main Authors: da Silva, Leila, Miranda, Angélica, Batalha, Rosieny, Ferreira, Luiz, Santos, Mayara, Talhari, Sinésio
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01.11.2015; Contexto; Elsevier; Brazilian Society of Infectious Diseases
• Subjects: Adolescent; Adult; Brazil - epidemiology; Brazilian Amazon; Care and treatment; Causes of; CD4 Lymphocyte Count; Cervical cancer; Complications and side effects; Cross-Sectional Studies; DNA, Viral - analysis; Female; Health aspects; HIV; HIV infection; HIV infection in women; HIV Infections - complications; HPV; Humans; INFECTIOUS DISEASES; Middle Aged; Original; Papanicolaou Test; Papillomavirus infections; Papillomavirus Infections - complications; Papillomavirus Infections - epidemiology; Precancerous Conditions - epidemiology; Precancerous Conditions - pathology; Precancerous Conditions - virology; Prevalence; Risk Factors; Socioeconomic Factors; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - virology; Viral Load; Women; Young Adult; Brazil; Brazilian Amazon; HIV; Cervical cancer; HPV
• ISSN: 1413-8670; 1678-4391; 1678-4391
• DOI: 10.1016/j.bjid.2015.07.001

The goal of this study was to determine the prevalence of human papillomavirus infection infection and cervical lesions and its associated factors among HIV infected women attending an AIDS clinic in Amazonas state, Brazil. Cross-sectional study. Women attending an AIDS clinic in the city of Manaus between March and December 2011 for gynecological examination were invited to participate. Enrolled patients answered a standardized interview including demographical, behavioral, and clinical data. Additionally, patients underwent a gynecological evaluation with collection of cervical samples for cytological analysis and high-risk human papillomavirus infection hybrid capture. A blood sample was also obtained to determine CD4 and viral load levels. A total of 310 (82.9%) women participated in the study. High-risk human papillomavirus infection was detected in 191 (61.6%) cases; 24 (13.5%) had low-grade squamous intraepithelial lesion (SIL) and 4 (2.2%) high-grade SIL. No invasive cervical cancer was diagnosed. Median age was 32 (interquartile range (IQR): 27–38) years and median of education was 8.5 (IQR 4–11) years of schooling and 56.1% had a monthly income up to US$180. In multivariate analysis, being less than 30 years old [OR=1.7 (95% CI: 1.2–2.4, p=0.005)], high-grade SIL [OR=6.5 (95% CI: 1.6–23.0, p=0.009)], and CD4 counts <200cells/mm3 [OR=1.6 (95% CI: 1.2–2.0, p<0.001)] were associated with high risk human papillomavirus infection infection. In the present study high-risk human papillomavirus infection was frequent and it was associated to high-SIL. These results show the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.