High-risk cervical human papillomavirus infections among human immunodeficiency virus-positive women in the Bahamas.
BACKGROUND
High-risk (HR) HPV genotypes other than 16 and 18 have been detected in a significant proportion of immunocompromised females. We aim to evaluate the frequency of HR HPV genotypes in a population of HIV-positive Caribbean women.


METHODS
One hundred sixty-seven consecutive, non-pregnant, HIV-positive females ≥18 years were recruited in this study. Each participant received a vaginal examination, PAP smear, and completed a questionnaire. DNA was extracted for HPV testing in 86 patients.


RESULTS
Mean age was 39.1 years for women positive for HR HPV and 43.1 years for women negative for HR HPV (P value  = 0.040). 78% (130/167) of the women had HR HPV infections; the prevalence of abnormal cervical cytology was 38% among women who were HR HPV-positive compared to women who were HR HPV-negative (22%). Fifty-one percent of the 86 women with available genotype carried infections with HPV 16 and/or HPV 18; genotypes of unknown risk were also frequently observed. Women who had a CD4+ count of ≤200 had 7 times increased odds of carrying HR HPV infection in comparison to women with CD4+>200.


CONCLUSIONS
HR HPV infections in HIV infected females may consist of more than just HPV 16 and 18, but also HPV 52 and 58. Further studies are needed to determine whether HPV 52 and 58 play a significant role in the development of cervical cytological abnormalities in HIV+ women.
Department of Medicine, Princess Margaret Hospital, Nassau, Bahamas.
Dionne N
DN
Dames
Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple University Health System, Philadelphia, PA, USA.
Elizabeth
E
Blackman
Department of Obstetrics & Gynecology, Princess Margaret Hospital, Nassau, Bahamas.
Raleigh
R
Butler
Department of Population Health, North Shore Long Island Jewish/Hofstra School of Medicine, Manhasset, NY, USA.
Emanuela
E
Taioli
Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health and the University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
Stacy
S
Eckstein
Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA, USA.
Karthik
K
Devarajan
Department of Obstetrics & Gynecology, Princess Margaret Hospital, Nassau, Bahamas.
Andrea
A
Griffith-Bowe
Department of Medicine, Princess Margaret Hospital, Nassau, Bahamas.
Perry
P
Gomez
Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple University Health System, Philadelphia, PA, USA.
Camille
C
Ragin
D000328:Adult; D000368:Aged; D001444:Bahamas / Q000453:epidemiology; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D060085:Coinfection / Q000453:epidemiology / Q000821:virology*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology*; D052162:Human papillomavirus 16 / Q000235:genetics*; D052161:Human papillomavirus 18 / Q000235:genetics*; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology / Q000821:virology*; D015995:Prevalence; D012306:Risk; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology; D055815:Young Adult