Cervical cytological abnormalities and HPV infection in perinatally HIV-infected adolescents

• Main Authors: J. Ananworanich (Author), W. Prasitsuebsai (Author), S.J. Kerr (Author), R. Hansudewechakul (Author), N. Teeratakulpisarn (Author), K. Saisawat (Author), R. Ramautarsing (Author), J. Achalapong (Author), K. Pussadee (Author), S. Keadpudsa (Author), T. Mackay (Author), T. Pankam (Author), P. Rodbamrung (Author), W. Petdachai (Author), K. Chokephaibulkit (Author), A.H. Sohn (Author), N. Phanuphak (Author)
• Format: Book
• Published: Elsevier, 2015-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2055-6640; 10.1016/S2055-6640(20)31146-8
• Keywords: perinatal HIV; HPV; cervix; adolescents; Pap smear; Microbiology; QR1-502; Public aspects of medicine; RA1-1270
• Source: Journal of Virus Eradication, Vol 1, Iss 1, Pp 30-37 (2015)

Background: Behaviourally HIV-infected adolescent females are at higher risk for abnormal cervical cytology and HPV infection compared to those who are uninfected, but data on perinatally HIV-infected adolescent females are lacking. Methods: Cervical cytology, HPV infection and E6/E7 mRNA were assessed in sexually active 12-24-year-old adolescent females: perinatally HIV-infected (group 1, n=40), behaviourally HIV-infected (group 2, n=10), and HIV-uninfected (group 3, n=10). Results: Median age was lower in group 1 (18 years) than in groups 2 (24 years) and 3 (20.5 years) (P<0.001), and median time since sexual debut was shorter: 2 vs 5 vs 4 years (P<0.001). More trial participants in group 1 than group 2 were on antiretrovirals (90% vs 70%; P<0.001). Abnormal cervical cytology (atypical squamous cells of undetermined significance and higher) was observed in 30% (group 1), 40% (group 2) and 30% (group 3) (P=0.92), whereas high-risk HPV infection was observed in 45%, 45% and 40%, respectively (P=1.00). Positive E6/E7 mRNA was found in 28% of group 1, but not in other groups. High-risk HPV infection predicted abnormal cytology in all groups [OR 6.77, 95% confidence interval (CI) 1.99-23.0; P=0.001). Additionally, plasma HIV RNA ≥50 copies/mL (OR 13.3, 95% CI 1.16-153.06; P=0.04) predicted abnormal cytology in HIV-infected adolescent females. Conclusions: Despite the younger age and shorter time since sexual debut, cervical cytological abnormalities and HPV infection were as common in perinatally HIV-infected as in behaviourally infected and uninfected adolescents. HPV vaccination, pre-cancer screening and antiretroviral treatment in HIV-infected female adolescents should be implemented to minimise the risk of cervical cancer.