Human Papillomavirus infection and cervical lesions in HIV infected women on antiretroviral treatment in Thailand

• Main Authors: Delory T., Ngo-Giang-Huong N., Rangdaeng S., Chotivanich N., Limtrakul A., Putiyanun C., Suriyachai P., Matanasarawut W., Jarupanich T., Liampongsabuddhi P., Heard I., Jourdain G., Lallemant M., Le Coeur S., Zarca K., Brunet-Possenti F., Blake A., Althaus T., Gallot C., Desbiolles A., Fayard F., Dib F., Le Pluart D., Proute M., Tiv M., Banchongkit S., Bowonwatanuwong C., Buranabanjasatean S., Chutanunta A., Eiamsirikit N.
• Format: Journal
• Published: 2017
• Online Access: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85015384329&origin=inward; http://cmuir.cmu.ac.th/jspui/handle/6653943832/40525
• Institution: Chiang Mai University

© 2017 The British Infection Association Objectives To estimate the prevalence and factors associated with Human Papillomavirus (HPV) infection, HPV genotypes and cytological/histological high-grade (HSIL+/CIN2+) lesions. Methods We conducted a cross-sectional study within a prospective cohort of HIV-infected women on combination antiretroviral therapy (cART). Cervical specimens were collected for cytology and HPV genotyping (Papillocheck ® ). Any women with High-Risk-HPV (HR-HPV), and/or potentially HR-HPV (pHR-HPV) and/or ASC-US or higher (ASC-US+) lesions were referred for colposcopy. Factors associated with HR-HPV infection and with HSIL+/CIN2+ lesions were investigated using mixed-effects logistic regression models. Results 829 women were enrolled: median age 40.4 years, on cART for a median of 6.9 years, median CD4 cell-count 536 cells/mm3, and 788 (96%) with HIV-viral load < 50copies/mL. Of 214 (26%) infected with HPV: 159 (19%) had ≥1 HR-HPV, of whom 38 (5%) HPV52, 22 (3%) HPV16, 9 (1%) HPV18; 21 (3%) had pHR-HPV, 34 (4%) low risk-HPV infection, and 56 (26%) had multiple genotypes. Younger age, low CD4 cell-counts and low education were independently associated with HR-HPV infection. 72 women (9%) had ASC-US+ and 28 (3%) HSIL+/CIN2+ lesions. HR-HPV infection was independently associated with HSIL+/CIN2+ lesions. Conclusion The prevalence of HPV infection and of cervical lesions was low. The HPV genotype distribution supports the use of 9-valent vaccine in Thailand.