Studies in various regions of the world have shown that women infected with HIV-1 are at increased risk for cervical human papillomavirus (HPV) infection as well as for cervical cancer precursor lesions. HIV infection and cervical cancer are both widespread in West Africa, but little is known about the relationship between HPV and HIV-2, which is the predominant type of HIV in the general population of many West African countries. To address this issue, we collected cervical samples for cytology and HPV analysis from 93 women presenting to the University of Dakar Infectious Disease Service (18 women with HIV-1 infection, 17 with HIV-2 infection, and 58 HIV seronegative controls). Compared to those without HIV infection, HIV seropositive women were 13.1 (95% CI = 2.4, 128) and 11.0 (95% CI = 3.5, 35.8) times more likely to have HPV detected using Southern transfer hybridization (STH) and the polymerase chain reaction (PCR) respectively. Detection of high and intermediate risk HPV types were significantly associated with HIV-1 and HIV-2 infection. Among HPV positive women, those with, as compared to those without HIV infection were more likely to harbour high risk HPV types (OR = 9.2, 95% CI = 0.97, 433). HIV-1 and HIV-2 seropositive women were 23.3 (95% CI = 2.9, 209) and 9.3 (95% CI = 1.1, 79) times more likely to have cytological diagnosis of dysplasia, respectively, than were HIV seronegative women. Biopsy-proven CIN 3 was found in one woman with HIV-1 and invasive cancer was found in one woman with HIV-2.(ABSTRACT TRUNCATED AT 250 WORDS)
PIP: Studies in various regions of the world have shown that women infected with HIV-1 are at increased risk for cervical human papillomavirus (HPV) infection as well as for cervical cancer precursor lesions. HIV infection and cervical cancer are both widespread in West Africa, but little is known about the relationship between HPV and HIV-2, the predominant type of HIV in the general population of many West African countries. The authors report findings from their collection of cervical samples for cytology and HPV analysis from 93 women presenting to the University of Dakar Infectious Disease Service; 18 women infected with HIV-1, 17 with HIV-2, and 58 HIV seronegative controls. Compared to those without HIV infection, HIV seropositive women were 13.1 and 11.0 times more likely to have HPV detected using Southern transfer hybridization and the polymerase chain reaction, respectively. The detection of high and intermediate risk HPV types was significantly associated with HIV-1 and HIV-2 infection. Among HPV-positive women, those infected with HIV were more likely to harbor high-risk HPV types. HIV-1 and HIV-2 seropositive women were 23.3 and 9.3 times more likely to have a cytological diagnosis of dysplasia, respectively, than were HIV-seronegative women. Biopsy-proven cervical intraepithelial neoplasia (CIN) 3 was found in one woman with HIV-1 and invasive cancer was found in one woman with HIV-2. It remains unclear, however, whether HIV-1 and HIV-2 confer similar risks of developing CIN 2-3 and the potential of invasive cervical cancer.