Human Papillomavirus (HPV) Infection And Its Association With Cervical Dysplasia Among HIV Positive Women Attending Art Clinic, Korle-Bu Teaching Hospital, Accra

Abstract

Globally, about 35 million people are living with HIV of which 16 million are women aged 15 years and above, 80% of whom live in the Sub-Saharan African region These women living with HIV (WLHIV), especially those having low CD4 T-cell counts are more likely to be infected with human papillomaviruses (HPV), which are the major cause of cervical cancer and it’s precursor lesions. But less is known about the prevalence of HPV infection and the specific types involved in this particular population of women in Ghana. A cross-sectional study was carried out to establish the distribution of genital HPV genotypes among an unscreened population of WLHIV attending a special HIV outpatient clinic at the Korle-Bu Teaching hospital (KBTH) Accra, Ghana. Cervical swabs were available for 538 eligible women. A nested multiplex PCR (NMPCR) assay was conducted for the detection and typing of HPV genotypes 6/11, 16,18, 31, 33, 35, 39, 42, 43, 44, 45, 51, 52, 56, 58, 59, 66, and 68. Cervical smears were also prepared and examined independently for cytologic abnormalities by two cytologists and confirmed by a pathologist. HPV DNA was detected in 52.0% of all cervical swabs tested, the prevalence of LR (Low Risk) HPV was 10.2% (95% CI: 11.3 – 17.6). while that of HR (High Risk) HPV was 29.7% (95% CI: 27.4 – 35.7). The commonest HR types were, HPV-35 (14.1%), HPV-18 (13.0%;), HPV-58 (7.4%;), HPV-52 (7.2%;), HPV-45 (4.8%;) and HPV 42, a low-risk type, was also common (7.8%;). The frequency of HPV 16 was 2.4%. Cytologicaly, 2.8% had ASCUS, 3.9% LGSIL and 2.8% HGSIL, None of the women was found to have atypical glandular cells or adenocarcinoma. There is a high burden of HPV in women living with HIV attending clinic at the KBTH. I recommend that screening for cervical dysplasia should be done for WLHIV routinely as part of their comprehensive care.