High prevalence of oncogenic human papillomavirus in the genital tract of women with human immunodeficiency virus

Objective. The goal of this study was to determine the prevalence of human papillomavirus (HPV) and squamous intraepithelial lesions (SILs) in women i nfected with human immunodeficiency virus (HIV) in Mexico. Methods. Cases included women who were positive for human immunodeficiency virus (HIV) and accepted to participate. There were two control groups in t his study: group A, heterosexual partners of HIV+ men; group B, commercial sex workers. Gynecologic examination was performed in all participants. Als o, a cervical smear with colposcopy and a sample for detection of HPV DNA b y polymerase chain reaction (PCR) were obtained in all subjects, as were CD 4+ counts. Relative risks (RR) and 95% confidence interval were calculated. Results. Eighty-five HIV+ women agreed to participate in this study; the ro ute of HIV infection was heterosexual in 78.88; transfusion in 8.2%; paid d onors in 3.5%; and 9.4% unknown. A total of 9 controls were included: 4 fro m group A and 5 from group B, HPV DNA was detected by PCR in 57 (69%) cases and in 26 (29%) controls from both groups (P < 0.0001). The RR of HPV infe ction was 5.5 (2.7-11.5), Also, a significant difference in the prevalence of high-risk HPV types was observed between cases and controls, RR = 12.8 ( 4.07-42.9), These associations were independent of CD4+ counts and antiretr oviral therapy. No association was observed between HIV infection and the r isk for high-grade SIL. Conclusions. We observed a high prevalence of oncogenic HPV types in HIV-po sitive women, These women should be screened regularly for early diagnosis of premalignant lesions and prevention of cervical cancer. (C) 2001 Academi c Press.