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

• Main Authors: Tristan Delory, Nicole Ngo-Giang-Huong, Samreung Rangdaeng, Nantasak Chotivanich, Aram Limtrakul, Chaiwat Putiyanun, Pornnapa Suriyachai, Wanmanee Matanasarawut, Tapnarong Jarupanich, Prateung Liampongsabuddhi, Isabelle Heard, Gonzague Jourdain, Marc Lallemant, Sophie Le Coeur, Kevin Zarca, Florence Brunet-Possenti, Alexandre Blake, Thomas Althaus, Céline Gallot, Alice Desbiolles, Florence Fayard, Fadia Dib, Diane Le Pluart, Myrtille Proute, Métrey Tiv, Sukit Banchongkit, Chureeratana Bowonwatanuwong, Sudanee Buranabanjasatean, Apichat Chutanunta, Naree Eiamsirikit
• Format: Journal
• Published: 2018
• Subjects: Medicine
• Online Access: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85015384329&origin=inward; http://cmuir.cmu.ac.th/jspui/handle/6653943832/57714
• 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.