title: High-risk human papillomavirus among HIV-infected women with normal cervical cytology: a pilot study in Jos, Nigeria.
abstract: BACKGROUND
  Cervical cancer is strongly linked to high-risk human papillomavirus (HR-HPV) and is typically preceded by cytological abnormalities. Less is known in patients with normal cervical cytology (NCC). We investigated the epidemiology of HR-HPV among HIV-infected women with NCC.
  
  
  METHODS
  We conducted a cross-sectional study between January and June 2011 among HIV-infected women with NCC at an adult HIV clinic in Jos, Nigeria. Cervical sampling and analysis for HR-HPV by hybrid capture (HC2) with signal amplification was done to determine presence of one or more of the following HR-HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 or 68. Epidemiologic factors associated with HR-HPV were determined using bivariate statistics and multivariate logistic regression.
  
  
  RESULTS
  We evaluated 103 HIV-infected women with Pap cytology. The median age of the women was 32 years (range 21-49). Ninety-seven (94.2%) had NCC. Cervical samples for HR-HPV DNA testing were available from 89/97 (91.8%) of the HIV-infected women with NCC. Of the 89 women with cervical samples for HR-HPV DNA testing, 40 (44.9%) had detectable HR-HPV by HC2 giving a HR-HPV prevalence of 44.9% (95% CI 33.9-55.5%). Age < 30 years was associated with HR-HPV (OR 2.69 [95% CI 1.05-6.91, p = 0.039]) while history of previous abortion showed an inverse association with HR-HPV (OR 0.33[95% CI 0.15-0.94, p = 0.039]).
  
  
  CONCLUSIONS
  The prevalence of HR-HPV is seemingly high among HIV-infected women with NCC in our clinical setting. These data provide support for further investigation of the clinical implications of positive HR-HPV among HIV-infected women with NCC report in cervical cancer prevention programs in Nigeria.
authors.affiliation: Department of Obstetrics and Gynecology, University of Jos, Jos, Nigeria, drmusaj@yahoo.com.
authors.forename: Jonah
authors.initials: J
authors.lastname: Musa
authors.forename: Babafemi
authors.initials: B
authors.lastname: Taiwo
authors.forename: Chad
authors.initials: C
authors.lastname: Achenbach
authors.forename: Silas
authors.initials: S
authors.lastname: Olugbenga
authors.forename: Baiba
authors.initials: B
authors.lastname: Berzins
authors.forename: Atiene S
authors.initials: AS
authors.lastname: Sagay
authors.forename: John A
authors.initials: JA
authors.lastname: Idoko
authors.forename: Phyllis J
authors.initials: PJ
authors.lastname: Kanki
authors.forename: Robert L
authors.initials: RL
authors.lastname: Murphy
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D010865:Pilot Projects; D011247:Pregnancy; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000473:pathology