title: Prevalence of human papillomavirus infection, distribution of viral types and risk factors in cervical samples from human immunodeficiency virus-positive women attending three human immunodeficiency virus-acquired immune deficiency syndrome reference centres in northeastern Brazil.
abstract: Human immunodeficiency virus (HIV)-positive patients have a greater prevalence of coinfection with human papillomavirus (HPV) is of high oncogenic risk. Indeed, the presence of the virus favours intraepithelial squamous cell lesion progression and may induce cancer. The aim of this study was to evaluate the prevalence of HPV infection, distribution of HPV types and risk factors among HIV-positive patients. Cervical samples from 450 HIV-positive patients were analysed with regard to oncotic cytology, colposcopy and HPV presence and type by means of polymerase chain reaction and sequencing. The results were analysed by comparing demographic data and data relating to HPV and HIV infection. The prevalence of HPV was 47.5%. Among the HPV-positive samples, 59% included viral types of high oncogenic risk. Multivariate analysis showed an association between HPV infection and the presence of cytological alterations (p = 0.003), age greater than or equal to 35 years (p = 0.002), number of partners greater than three (p = 0.002), CD4⁺ lymphocyte count < 200/mm³ (p = 0.041) and alcohol abuse (p = 0.004). Although high-risk HPV was present in the majority of the lesions studied, the low frequency of HPV 16 (3.3%), low occurrence of cervical lesions and preserved immunological state in most of the HIV-positive patients were factors that may explain the low occurrence of precancerous cervical lesions in this population.
authors.affiliation: Laboratório de Imunogenética, Centro de Pesquisas Aggeu Magalhães-Fiocruz, Recife, PE, Brasil.
authors.forename: Albert Eduardo Silva
authors.initials: AE
authors.lastname: Martins
authors.affiliation: Laboratório de Imunogenética, Centro de Pesquisas Aggeu Magalhães-Fiocruz, Recife, PE, Brasil.
authors.forename: Norma
authors.initials: N
authors.lastname: Lucena-Silva
authors.affiliation: Laboratório de Imunogenética, Centro de Pesquisas Aggeu Magalhães-Fiocruz, Recife, PE, Brasil.
authors.forename: Renan Gomes
authors.initials: RG
authors.lastname: Garcia
authors.affiliation: Centro Integrado de Saúde Amaury de Medeiros, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recif, PE, Brasil.
authors.forename: Stefan
authors.initials: S
authors.lastname: Welkovic
authors.affiliation: Departamento Materno-Infantil, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brasil.
authors.forename: Aureliana
authors.initials: A
authors.lastname: Barboza
authors.affiliation: Departamento Materno-Infantil, Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, PE, Brasil.
authors.forename: Maria Luiza Bezerra
authors.initials: ML
authors.lastname: Menezes
authors.affiliation: Hospital Correia Picanço, Secretaria de Saúde de Pernambuco, Recife, PE, Brasil.
authors.forename: Magda
authors.initials: M
authors.lastname: Maruza
authors.affiliation: Departamento Materno-Infantil, Universidade Federal de Pernambuco, Recife, PE, Brasil.
authors.forename: Terezinha
authors.initials: T
authors.lastname: Tenório
authors.affiliation: Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, PE, Brasil.
authors.forename: Ricardo A A
authors.initials: RA
authors.lastname: Ximenes
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000821:virology*; D000328:Adult; D000428:Alcohol Drinking; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000821:virology*; D060085:Coinfection / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006678:HIV / Q000276:immunology; D015528:HIV Seroprevalence; D006801:Humans; D007182:Income; D027383:Papillomaviridae / Q000145:classification* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers