Introduction Persistent infection with high-risk human papillomavirus (HR-HPV) is necessary for the development of precursor lesions and cervical cancer. HPV infection among women living with HIV/AIDS (WLHA) occurs more frequently, presents a higher parcel of persistent infections and an earlier progression to cancer. We aimed to evaluate the HR-HPV infection and clearance, and its association with HIV viral suppression, immunological response, and other risk factors among WLHA followed in a STD/HIV reference centre.
Methods This is a cohort study conducted at a reference centre for STD/AIDS in Northeastern Brazil from September 2013 to September 2015. Follow-up visits were conducted at 6 and 12 months from enrolment, where socio-epidemiological data was obtained through standardised form. Cervical samples were collected for conventional cytology and HPV DNA research (PCR COBAS Roche) in addition to blood samples for TCD4+ lymphocyte count and HIV viral load.
Results We prospectively evaluated 333 women. HR-HPV DNA prevalence was 39.6% during the follow-up. HPV-16 was present in 6.0%, HPV-18 in 5.4% and 37.8% WLHA had other HR-HPV (31,33,35,39,45,51,52,56,58,59,66 and 68). The HR-HPV incidence was 10.6% in 6 months visit and 6.5% in 12 months visit. Variables associated with HR-HPV incidence were: age ≤30 years, combined oral contraceptive use, smoking and detectable HIV viral load. The HR-HPV clearance was 31.7% and was associated with age >30 years and lymphocytes count >350 cels/mm3 at enrolment. Nulliparous women had higher HR-HPV clearance rates.
Conclusion These findings have contributed to the knowledge about the group of women that need a more careful HPV screening, while described the association of efficient immunological response and HIV viral suppression with a lower HR-HPV incidence and increased clearance of HPV-HR.