HPV Infection and Intraepithelial Lesions: Comparison Between HIVPositive and Negative Women

M.      Roccio; B.      Dal Bello; B.      Gardella; M.      Carrara; R.      Gulminetti; B.      Mariani; A.      Spinillo

Abstract

Introduction: Human Papillomavirus infections have been shown to be crucial for the development of cervical intraepithelial neoplasia and subsequent cervical cancer. The aim of this study is to describe the prevalence of different genotypes of HPV, in a population of HIV-positive women, compared to the negative ones, and their oncogenic risk.

Patients and Method: A case-control study comparing HPV genotype distribution between 93 HIV-seropositive and 186 HIV-seronegative women, matched for age and severity of cervical lesions, who attending colposcopic service of our departments for periodical Pap smear and HPV DNA full genotyping by SPF-10 LiPA assay.

Results: No significant difference was found in genotype distribution between HIV positive and HIV negative women. Only the prevalence of HPV56 was higher in HIV positive women (p=0,046). The rates of HPV 6, 11, 16 and 18 were similar in both groups. The likelihood of the detection of three or more HPV genotypes was significantly associated with CIN (OR=2.0; 95% CI=1.1–3.8; p= 0.026) but only marginally to HIV-positive serostatus (OR=1.68; 95% CI=0.89–3.16; p= 0.1). High grade cervical lesions are associated with high risk viruses like HPV 16 and 18 and with multiple cervical HPV infections.

Conclusions: The tendency to treat HIV disease with high active antiretroviral therapy may reduce the impact of immunosuppression and make the course of such HPV infections more similar to that among women who are not HIVinfected. As in immunocompetent women, high oncogenic risk viral type and multiple infections are associated with a histologically proven cervical intraepithelial lesions.

Keywords: HIV, cevical intraepithelial neoplasia, HPV genotypes, immunosuppression, antiretroviral therapy, oncogenic risk

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