The impact of human immunodeficiency virus and human papillomavirus co-infection on HPV genotype distribution and cervical lesion grade in a semi-urban population in Tigoni, Kenya

Abstract

Background: Cervical cancer, a common cause of death among women, is attributable to human papilloma virus (HPV). Human immunodeficiency virus (HIV) infection can potentially alter the incidence of cervical cancer. Prophylactic HPV vaccines are a major advance against cervical cancer. Epidemiological research on HPV and cervical cancer is therefore justified. Objective: To determine the impact of HIV and HPV co-infection on the HPV genotype distribution and cervical lesion grade in Tigoni, Kenya. Methodology: This was a cross-sectional study. Women aged 25 to 60 years were invited for cervical cancer and HIV screening. HPV typing was done by PCR on residual cervical samples after cytology reporting. Results: Of 438 samples, 140 (31.96%) were positive for at least one type of HPV. The most frequent HPV types were 16, 56, 53, 35, and 39. When co-infection with HIV was examined, 37 (32.5%) were HPV-/HIV+, 63 (19.4%) were HPV+/HIV-, 77 (67.5%) were HPV+/HPV+ (p<0.0001). High risk (HR)-types were the more frequent across all positive samples; HR-HPV+/HIV+ were 43 (37.7%), (p<0.0001). Conclusion: HIV infection was a significant risk factor in HPV infection with 65.5% of cases being both HPV and HIV infected. Over 77% of those individuals who had a CIN III or greater were HPV positive. HR-HPV types were found across all diagnostic categories in the cases that had a cervical tissue biopsy with HPV type 16 being the most dominant type, particularly in high grade lesions.