title: Presence of multiple human papillomavirus types in cervical samples from HIV-infected women.
abstract: OBJECTIVE
  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.
authors.affiliation: Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo SP, Brazil. dudilevi@usp.br
authors.forename: José Eduardo
authors.initials: JE
authors.lastname: Levi
authors.forename: Silvana
authors.initials: S
authors.lastname: Fernandes
authors.forename: Adriana Fumie
authors.initials: AF
authors.lastname: Tateno
authors.forename: Eduardo
authors.initials: E
authors.lastname: Motta
authors.forename: Liliam Pereira
authors.initials: LP
authors.lastname: Lima
authors.forename: José
authors.initials: J
authors.lastname: Eluf-Neto
authors.forename: Cláudio Sérgio
authors.initials: CS
authors.lastname: Pannuti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D016133:Polymerase Chain Reaction; D014412:Tumor Virus Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000821:virology*; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000276:immunology / Q000821:virology*