Factors associated with increased prevalence of human papillomavirus infection in a cohort of HIV-infected Brazilian women.
OBJECTIVE
Human papillomavirus (HPV) infection is a major risk factor for cervical disease. Using baseline data from the HIV-infected cohort of Evandro Chagas Clinical Research Institute at Fiocruz, Rio de Janeiro, Brazil, factors associated with an increased prevalence of HPV were assessed.


METHODS
Samples from 634 HIV-infected women were tested for the presence of HPV infection using hybrid capture II and polymerase chain reaction. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance.


RESULTS
The overall prevalence of HPV infection was 48%, of which 94% were infected with a high-risk HPV. In multivariate analysis, factors independently associated with infection with high-risk HPV type were: younger age (<30 years of age; PR 1.5, 95% confidence interval (CI) 1.1-2.1), current or prior drug use (PR 1.3, 95% CI 1.0-1.6), self-reported history of HPV infection (PR 1.2, 95% CI 0.96-1.6), condom use in the last sexual intercourse (PR 1.3, 95% CI 1.1-1.7), and nadir CD4+ T-cell count <100cells/mm(3) (PR 1.6, 95% CI 1.2-2.1).


CONCLUSIONS
The estimated prevalence of high-risk HPV-infection among HIV-infected women from Rio de Janeiro, Brazil, was high. Close monitoring of HPV-related effects is warranted in all HIV-infected women, in particular those of younger age and advanced immunosuppression.
Grinsztejn
Beatriz
B
Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. gbeatriz@ipec.fiocruz.br
Veloso
Valdilea Gonçalves
VG
Levi
José Eduardo
JE
Velasque
Luciane
L
Luz
Paula Mendes
PM
Friedman
Ruth Khalili
RK
Andrade
Angela Cristina
AC
Moreira
Ronaldo Ismerio
RI
Russomano
Fabio
F
Pilotto
José Henrique
JH
Bastos
Francisco Inacio
FI
Palefsky
Joel
J
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult