HPV infection and pre-neoplastic cervical lesions among 321 HIV+ women in Florence, Italy, 2006-2016: prevalence and associated factors

• Published in: The New microbiologica Vol. 41; no. 4; pp. 268 - 273
• Main Authors: Fusco, Francesco Maria, Vichi, Francesca, Bisanzi, Simonetta, Sani, Cristina, Degli Esposti, Anna, Blè, Claudio, Rossi, Riccardo, Pompeo, Giampaolo, Carozzi, Francesca, Blanc, Pierluigi
• Format: Journal Article
• Language: English
• Published: Italy Edizioni Medico Scientifiche 01-10-2018
• Subjects: Biopsy; Cancer; Cervical Intraepithelial Neoplasia - complications; Cervical Intraepithelial Neoplasia - epidemiology; Cervix; Cigarettes; Colposcopy; Demographics; Female; Genotype; Genotypes; Health risks; HIV; HIV - genetics; HIV Infections - complications; Human immunodeficiency virus; Human papillomavirus; Humans; Infections; Italy; Lesions; Papillomaviridae; Papillomavirus Infections - complications; Papillomavirus Infections - epidemiology; Prevalence; Risk Factors; Smoking; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - epidemiology; Vaccines; Italy; HIV/AIDS; pre-neoplastic cervical lesions; HPV vaccination; HPV
• ISSN: 1121-7138

Women living with HIV (WLWH) are at higher risk for HPV-related malignancies. To estimate the factors associated to HPV infection and to pre-neoplastic cervical lesions, we observed 321 WLWH in an HIV care-centre in Florence, Italy. In 2006-2016, WLWH followed at S. Maria Annunziata Hospital underwent to gynaecological examination including HPV-test, Pap-smear, colposcopy and, if needed, cervical biopsy. Demographical and clinical information were collected and linear logistic regression was performed. Among 321 WLWH, 161 (50.2%) resulted HPV+. Multiple genotypes were identified in 35%, and cancer high-risk genotypes in 61%. Younger age, not-caucasic origin, increasing number of partners, and shorter duration of HIV are associated with HPV infection. A colposcopy was performed in 154 HIV+/HPV+ women: histological lesions were present in 47 (30%). Among these, CIN1, CIN2 and CIN3 were present in 16, 4, and 1 patients, respectively. Being caucasic, smoking 1-20 cigarettes/day, having 2 partners in the last year, and being an injective-drug-user are associated with cervical lesions. The use of bi-valent, 4-valent and 9-valent HPV vaccines would potentially prevent lesions in 19%, 33%, and 48%. Among WLWH efficaciously in care for HIV, demographic and behavioral factors mainly contribute to acquisition of HPV and to development of cervical lesions.