Persistent Low-Risk and High-Risk Human Papillomavirus Infections of the Uterine Cervix in HIV-Negative and HIV-Positive Women

Sally N Adebamowo; Oluwatoyosi Olawande; Ayotunde Famooto; Eileen O Dareng; Richard Offiong; Clement A Adebamowo; H3Africa ACCME Research Group

doi:10.3389/fpubh.2017.00178

Persistent Low-Risk and High-Risk Human Papillomavirus Infections of the Uterine Cervix in HIV-Negative and HIV-Positive Women

Front Public Health. 2017 Jul 21:5:178. doi: 10.3389/fpubh.2017.00178. eCollection 2017.

Authors

Sally N Adebamowo^{1

2

3}, Oluwatoyosi Olawande⁴, Ayotunde Famooto^{3

4}, Eileen O Dareng⁵, Richard Offiong⁶, Clement A Adebamowo^{1

2

3

7}; H3Africa ACCME Research Group

Affiliations

¹ Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United States.
² University of Maryland Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, United States.
³ Center for Bioethics and Research, Ibadan, Nigeria.
⁴ Office of Strategic Information and Research, Institute of Human Virology Nigeria, Abuja, Nigeria.
⁵ Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
⁶ Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Abuja, Nigeria.
⁷ Institute of Human Virology, University of Maryland School of Medicine, Baltimore, United States.

Abstract

Background: The prevalence, persistence, and multiplicity of human papillomavirus (HPV) infection appears different comparing HIV-positive to HIV-negative women. In this study, we examined prevalent, persistent, and multiple low- and high-risk cervical HPV infections in HIV-negative and HIV-positive women.

Methods: We studied 1,020 women involved in a study of HPV infection using SPF₂₅/LiPA₁₀. Two study visits were scheduled, at enrollment and 6 months afterward. At each study visit, research nurses used a cervical brush to collect samples of exfoliated cervical cells from the cervical os, from all the study participants. Exact logistic regression models were used to estimate associations between HIV and HPV infections.

Results: The mean (SD) age of the study participants was 38 (8) years, 56% were HIV-negative and 44% were HIV-positive. Among HIV-negative women at baseline, single low-risk HPV (lrHPV) infections occurred in 12%; multiple lrHPV in 2%; single high-risk human papillomavirus (hrHPV) infections in 9%, and multiple hrHPV infections in 2%. Single lrHPV infections were persistent in 6%, but there was no persistent multiple lrHPV infections. Single hrHPV infections were persistent in 4% while multiple hrHPV infections were persistent in 0.3%. Among HIV-positive women at baseline, single lrHPV infections occurred in 19%, multiple lrHPV in 6%, single hrHPV infections in 17%, and multiple hrHPV infections occurred in 12%. Single lrHPV infections were persistent in 9%, multiple lrHPV infections in 0.6%, single hrHPV infections in 13%, while multiple hrHPV were persistent in 3%. Prevalent, persistent, and multiple infections were more common in HIV-positive women, compared to HIV-negative women. In multivariate models adjusted for age, marital status, socioeconomic status, age at sexual initiation, and douching, the odds ratios comparing HIV-positive to HIV-negative women, were 2.09 (95% CI 1.47-2.97, p < 0.001) for prevalent lrHPV, 1.26 (95% CI 0.66-2.40, p 0.47) for persistent lrHPV infections, 3.38 (95% CI 2.34-4.87, p < 0.001) for prevalent hrHPV, and 4.49 (95% CI 2.26-8.91, p < 0.001) for persistent hrHPV infections.

Conclusion: HIV infection was associated with higher prevalence of lrHPV, hrHPV, and persistence hrHPV infections, but not persistent lrHPV infections.

Keywords: HIV; Nigeria; cervical cancer; human papillomavirus; persistence and multiple infections; prevalence.