title: Multiple human papillomavirus infections and HIV seropositivity as risk factors for abnormal cervical cytology among female sex workers in Nairobi.
abstract: We estimated type-specific prevalence of human papillomavirus (HPV) and examined risk factors for abnormal cervical cytology among 296 female sex workers from Nairobi, Kenya. Over half (54%) were infected with a high-risk (HR) HPV type, of which HPV16 and 52 were the most common types. HIV-1 prevalence was 23% and HIV-1 sero-positivity was associated with high-grade cervical lesions, particularly among women with CD4 count less than 500 cells/mm(3) (odds ratio [OR] = 6.9; 95% confidence interval [CI]: 1.7-24.9). Among women who had normal cytology at the time of entry into the study, the risk of having an abnormal Pap smear within one year was significantly elevated for women with multiple HPV types at study entry (adjusted odds ratio [aOR] = 6.0; 95% CI: 2.3-15.7) and with a subset of HR HPV types (aOR = 4.2; 95% CI: 1.6-11.2). Detection of multiple concurrent HPV infections may be a useful marker to identify women at risk of developing precancerous lesions in populations of high HPV prevalence.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Patel
authors.forename: N R
authors.initials: NR
authors.lastname: Mugo
authors.forename: C R
authors.initials: CR
authors.lastname: Cohen
authors.forename: J
authors.initials: J
authors.lastname: Ting
authors.forename: R
authors.initials: R
authors.lastname: Nguti
authors.forename: J
authors.initials: J
authors.lastname: Kwatampora
authors.forename: W
authors.initials: W
authors.lastname: Waweru
authors.forename: P
authors.initials: P
authors.lastname: Patnaik
authors.forename: G G
authors.initials: GG
authors.lastname: Donders
authors.forename: J
authors.initials: J
authors.lastname: Kimani
authors.forename: D L
authors.initials: DL
authors.lastname: Kenney
authors.forename: N B
authors.initials: NB
authors.lastname: Kiviat
authors.forename: J S
authors.initials: JS
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D006679:HIV Seropositivity / Q000150:complications* / Q000821:virology; D015497:HIV-1; D052162:Human papillomavirus 16; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D016133:Polymerase Chain Reaction; D011230:Precancerous Conditions / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D060386:Sex Workers; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control* / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control* / Q000821:virology
keywords: Africa; HIV; HPV; cervical dysplasia; human papillomavirus; sex workers; sexually transmitted infection