Cervical dysplasia and high-risk human papillomavirus infections among HIV-infected and HIV-uninfected adolescent females in South Africa.
BACKGROUND
HIV-infected adolescents may be at higher risk for high-grade cervical lesions than HIV-uninfected adolescents. The purpose of this study was to compare the prevalence of high-risk HPV (HR-HPV) infections and Pap smear abnormalities between these two groups.


METHODS
In this cross-sectional study, we compared the HPV DNA and Pap smear results between 35 HIV-infected and 50 HIV-uninfected adolescents in order to determine the prevalence of HR-HPV genotypes and cervical cytological abnormalities. Comparisons were made using Pearson χ (2) and independent-samples t-tests analyses, and associations between demographic and behavioral characteristics and HPV infections were examined.


RESULTS
HIV-infected participants were more likely to be infected with any HPV (88.6% versus 48.0%; P < 0.001) and with at least one HR-HPV (60.0% versus 24.0%; P = 0.001), and to have multiple concurrent HPV infections (68.6% versus 22.0%; P < 0.001). HPV 16 and 18 were relatively underrepresented among HR-HPV infections. Abnormal Pap test results were more common among HIV-infected participants (28.8% versus 12.0%; P = 0.054). A history of smoking was associated with HR-HPV infection.


CONCLUSIONS
HIV-infected adolescents have an increased risk of infection with HR-HPV and of Pap test abnormalities. The majority of HR-HPV infections among our participants would not be prevented by the currently available vaccinations against HPV.
Department of Emergency Medicine, University of Rochester, 601 Elmwood Avenue, P.O. Box 655, Rochester, NY 14642, USA.
David H
0000-0002-8797-1621
DH
Adler
Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
Melissa
0000-0001-7007-1910
M
Wallace
Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
Thola
0000-0002-1395-4714
T
Bennie
Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
Megan
M
Mrubata
Department of Emergency Medicine, University of Rochester, 601 Elmwood Avenue, P.O. Box 655, Rochester, NY 14642, USA.
Beau
0000-0003-1536-220X
B
Abar
Institute of Infectious Diseases & Molecular Medicine and Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
Tracy L
0000-0002-3706-4628
TL
Meiring
Institute of Infectious Diseases & Molecular Medicine and Division of Medical Virology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa ; National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa.
Anna-Lise
AL
Williamson
Desmond Tutu HIV Centre, Institute of Infectious Diseases & Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, Cape Town, South Africa.
Linda-Gail
LG
Bekker
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D006801:Humans; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D013019:South Africa / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology; D055815:Young Adult