Presence of multiple human papillomavirus types in cervical samples from HIV-infected women

Abstract

Objectives: The aim of this study was to detect and identify human papillomavirus (HPV) genotypes on a population of women infected by the human immunodeficiency virus (HIV) and to investigate the role of multiple infections on cervical dysplasia.

Methods: Two hundred and fifty-five HIV-infected women were enrolled on a study to evaluate the prevalence of HPV and cervical intra-epithelial neoplasia (CIN). A group of HIV-negative women with confirmed CIN diagnosis was included for comparison. A polymerase chain reaction (PCR)-reverse hybridization method was applied to detect and precisely identify HPV types, specifically multiple infections.

Results: On HIV patients, an altered Pap smear confirmed by biopsy was observed on 45 (18%); HPV-DNA prevalence was 87% (223/255), with 45% (116/255) infected by more than two types. In contrast, HPV-DNA was detected in all 36 women of the control group but only 3 were infected by more than two types. Cervical dysplasia was associated with low CD4 counts and elevated high-risk HPV viral load. However, the presence of multiple HPV types did not correlate with the degree of immune suppression or the presence of cervical lesions.

Conclusions: Infection with multiple HPV types is a rather frequent finding on Brazilian HIV-infected women. On this population, concomitant infection with three or more HPV types does not seem to confer an additional risk of cervical dysplasia in comparison to single/double infections, nor to be related to more severe immunesuppresion.