Concurrent Cervical and Anal High-Risk Human Papillomavirus Infection in Women Living With HIV: An Observational Case–Control Study
Background:
To evaluate the prevalence and correlates of concurrent uterine cervical and anal HR-HPV infections in women living with HIV (WLHIV).
Setting:
A cross-sectional study was undertaken at a tertiary care hospital and linked ART center.
Methods:
One hundred and forty-one WLHIV and 161 HIV-negative women were enrolled for cervical and anal cytology as well as HR-HPV testing using the HC2 method. Screen-positive women were followed-up with colposcopy/anoscopy and/or repeat cytology. Appropriate statistical tests were applied to assess the association of concurrent HR-HPV with various parameters.
Results:
Concurrent cervical and anal HR-HPV infection was detected in 22 WLHIV (16.3%) and 5 HIV-negative women (3.1%), the difference being statistically significant (P < 0.001). Among WLHIV, concurrent HR-HPV was associated with tobacco use (P < 0.001), receptive anal intercourse (P = 0.02), low CD4 counts (P = 0.001), and negatively with ART intake (P = 0.004) on bivariate analysis. Multivariate logistic regression analysis showed a positive association of concurrent HR-HPV positivity with tobacco use (P = 0.02) and low nadir CD4 counts (P = 0.03).
Conclusions:
WLHIV, especially those with CD4 counts less than 200/µL, should be offered HR-HPV screening and follow-up to detect cervical and anal lesions.