title: Human papillomavirus infection in HIV-1 infected women in Catalonia (Spain): implications for prevention of cervical cancer.
abstract: BACKGROUND
  High-risk human Papillomavirus infection is a necessary factor for cervical squamous intraepithelial lesions and invasive cervical cancer. In HIV-1-infected women, HPV infection is more prevalent and a higher risk of cervical cancer has been identified. We aimed to calculate the prevalence of infection by HR-HPV, determine the factors associated with this infection and abnormal cytology findings and to describe the history of cervical cancer screening in HIV-1-infected women.
  
  
  METHODS
  We enrolled 479 HIV-1-infected women from the PISCIS cohort. Each patient underwent a gynecological check-up, PAP smear, HPV AND Hybrid capture, HPV genotyping, and colposcopy and biopsy, if necessary. We applied questionnaires to obtain information on sociodemographic, behavioral, clinical, and cervical screening variables. We present a cross-sectional analysis.
  
  
  RESULTS
  Median age was 42 years. The prevalence of HR-HPV infection was 33.2% and that of high-grade squamous intraepithelial lesions (HSIL) was 3.8%. The most common genotypes were 16(23%), 53(20.3%), and 52(16.2%). The factor associated with HR-HPV infection was age <30 years (odds ratio[OR],2.5; 95%confidence interval[CI],1.1-5.6). The factors associated with the presence of HSIL or low-grade squamous intraepithelial lesions (LSIL) were CD4T-lymphocyte count <200 cells/mm(3) versus >500 cells/mm(3) (OR,8.4; 95%CI,3.7-19.2), HIV-1 viral load >10,000 copies/mL versus <400 copies/mL (OR,2.1; 95%CI,1.0-4.4), and use of oral contraceptives (OR,2.0; 95%CI,1.0-3.9). Sixty percent of HIV-1-infected women had had one Pap smear within the last 2 years.
  
  
  CONCLUSIONS
  The high prevalence of HPV infection and cervical lesions in the HIV-1-infected population in Catalonia, as well as the low coverage and frequency of screening in this group, means that better preventive efforts are necessary and should include vaccination against HPV, better accessibility to screening programs, training of health care professionals, and specific health education for HIV-1-infected women.
authors.affiliation: Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya, Institut Català d'Oncologia, Agència Salut Pública de Catalunya, Generalitat de Catalunya, Badalona, Spain. vstuardo@med.uchile.cl
authors.forename: Valeria
authors.initials: V
authors.lastname: Stuardo
authors.forename: Cristina
authors.initials: C
authors.lastname: Agustí
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Godinez
authors.forename: Alexandra
authors.initials: A
authors.lastname: Montoliu
authors.forename: Aureli
authors.initials: A
authors.lastname: Torné
authors.forename: Antoni
authors.initials: A
authors.lastname: Tarrats
authors.forename: Carmen
authors.initials: C
authors.lastname: Alcalde
authors.forename: Dolores
authors.initials: D
authors.lastname: Martín
authors.forename: Eulalia
authors.initials: E
authors.lastname: Fernández-Montoli
authors.forename: Cristina
authors.initials: C
authors.lastname: Vanrell
authors.forename: Josefa
authors.initials: J
authors.lastname: Solé
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Canet
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Marqueta
authors.forename: Jadiyettu
authors.initials: J
authors.lastname: Mohamed
authors.forename: Isabel
authors.initials: I
authors.lastname: Cuenca
authors.forename: Montserrat
authors.initials: M
authors.lastname: Lonca
authors.forename: Guillem
authors.initials: G
authors.lastname: Sirera
authors.forename: Elena
authors.initials: E
authors.lastname: Ferrer
authors.forename: Pere
authors.initials: P
authors.lastname: Domingo
authors.forename: Belen
authors.initials: B
authors.lastname: Lloveras
authors.forename: Josep María
authors.initials: JM
authors.lastname: Miro
authors.forename: Silvia
authors.initials: S
authors.lastname: De Sanjosé
authors.forename: Jordi
authors.initials: J
authors.lastname: Casabona
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000235:genetics / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000235:genetics / Q000821:virology; D011247:Pregnancy; D013030:Spain / Q000453:epidemiology; D014412:Tumor Virus Infections / Q000150:complications / Q000453:epidemiology / Q000235:genetics; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000235:genetics / Q000821:virology