Human papilloma virus types in the oral and cervical mucosa of HIV-positive South African women prior to antiretroviral therapy.
BACKGROUND
To evaluate the prevalence of human papilloma virus (HPV) infection and types in the oral and cervix mucosa of treatment-naïve HIV-1-positive women with CD4 counts less than 300 cells per ml with no HPV-associated oral lesions.


METHODS
Oral epithelium was harvested from the buccal mucosa and lateral borders of the tongue and cervical samples were collected from the endocervical area of 30 women, 22-64 years old. Cytobrush Plus cell collectors were used for sampling both anatomical areas. Genital pathology, obstetric and gynaecological history, co-morbid disease, hormone therapy, sexual behavior and smoking history were assessed via physical examination and clinical interviews. Special investigations included cervical Papanicolau smears, CD4 counts and HIV-1 viral loads. The linear array HPV test was used to determine HPV genotypes present in the specimens.


RESULTS
Oral HPV were identified in 20% (n = 6) of the patients, of which two had infection with two HPV types. Genital HPV was found in 96.7% (n = 29) of the women, of which only 14 had cytological abnormalities on Papanicolau smear. Infection with multiple HPV types were present in 93.1% (n = 27) of the patients, with an average of four HPV types per individual.


CONCLUSIONS
South African HIV-positive women with CD4 counts less than 300 cells per ml have a significant risk of cervical HPV strains and multiple strain infection of the cervix. The prevalence of HPV in normal oral mucosa was low but high-risk types were present. Limited correlation between oral HPV types and those identified in the cervical mucosa was found.
Richter
Karin L
KL
Department of Medical Virology, Tshwane Academic Division, National Health Laboratory Service and University of Pretoria, Pretoria, South Aftrica.
van Rensburg
Estrelita Janse
EJ
van Heerden
Willie F P
WF
Boy
Sonja C
SC
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology / Q000821:virology; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006679:HIV Seropositivity / Q000150:complications* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D009061:Mouth Mucosa / Q000821:virology; D009092:Mucous Membrane / Q000821:virology*; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics; D030361:Papillomavirus Infections / Q000139:chemically induced / Q000150:complications / Q000821:virology*; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa; D055815:Young Adult
D044966:Anti-Retroviral Agents; D004279:DNA, Viral