title: HPV infection-associated anogenital cyto-colpo-histological findings and molecular typing in HIV-positive women.
abstract: HIV and human papillomavirus (HPV) coinfection is increasing, especially in the anal canal (AC) and cervico-vaginal regions. We identified anal epithelium abnormalities related to high-risk HPV (HR-HPV) lesions in the lower genital tracts (LGTs) of HIV-positive women, described the HPV genotypes identified, and assessed the expression of E6/E7 oncogenes in coinfected patients. Ninety-eight women were enrolled in groups combining HIV status and presence or absence of HPV in the LGT. Anal and cervical smears were collected for cytology and HR-HPV assays using Cobas(®) and/or PapilloCheck(®). Samples with highly oncogenic HPV genotypes were confirmed by NucliSENS EasyQ(®). Forty-two HIV-positive (25-52; mean age 39.5) and 56 HIV-negative (18-58; mean age 35.7) patients were included. E2 and C1 groups presented AC alterations (P = 0.002); altered images for high-resolution anoscopy were higher in E1 and C2 (P < 0.001). Of the 29 women with alterations, 41.38% were HIV-negative and 58.62% were HIV-positive (P < 0.001). HIV-positive patients accounted for 29% of the anal high-grade squamous intraepithelial lesions (P = 0.015). The Cobas(®) positive result frequency was higher in three AC groups than in the other groups. There was variation in the number of HPV types in the cervico-vaginal samples among the study groups (P < 0.001). Anal cytology and anoscopy showed more altered findings in HIV-positive patients with HPV in the LGT. HR-HPV anal infections by various genotypes are common and are associated with cervical infections in HIV-positive patients. E6/E7 expression is apparently more common in the AC of HIV-positive women.
authors.affiliation: Núcleo de Prevenção de Doenças Ginecológicas, Departamento de Ginecologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: F K
authors.initials: FK
authors.lastname: Tso
authors.affiliation: Laboratório de Virologia, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: C L L
authors.initials: CL
authors.lastname: Rodrigues
authors.affiliation: Laboratório de Virologia, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: J E
authors.initials: JE
authors.lastname: Levi
authors.affiliation: Departamento de Patologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: M G
authors.initials: MG
authors.lastname: Mattosinho de Castro Ferraz
authors.affiliation: Núcleo de Prevenção de Doenças Ginecológicas, Departamento de Ginecologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: N M G
authors.initials: NM
authors.lastname: Speck
authors.affiliation: Núcleo de Prevenção de Doenças Ginecológicas, Departamento de Ginecologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
authors.forename: J C L
authors.initials: JC
authors.lastname: Ribalta
mesh_terms: D000293:Adolescent; D000328:Adult; D001003:Anal Canal / Q000473:pathology / Q000821:virology; D060085:Coinfection / Q000150:complications / Q000473:pathology / Q000821:virology*; D005260:Female; D005838:Genotype; D006678:HIV / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D015658:HIV Infections / Q000150:complications / Q000235:genetics / Q000473:pathology / Q000821:virology*; D006801:Humans; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000096:biosynthesis; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000150:complications / Q000235:genetics / Q000473:pathology / Q000821:virology*; D012333:RNA, Messenger / Q000096:biosynthesis; D012097:Repressor Proteins / Q000096:biosynthesis; D060737:Reproductive Tract Infections / Q000150:complications / Q000235:genetics / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears
chemical_list: C068651:E6 protein, Human papillomavirus type 16; D009856:Oncogene Proteins, Viral; D012333:RNA, Messenger; D012097:Repressor Proteins