Abstract:
Objective
To assess the baseline types of HPV infection among HIV‐positive and HIV‐negative women in western Kenya undergoing cryotherapy or loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia.
Methods
A prospective observational study was conducted of baseline HPV characteristics of women undergoing visual inspection with acetic acid (VIA) and cryotherapy or LEEP. After a positive VIA in HIV‐positive and HIV‐negative women, data on demographics, CD4 count, and use of antiretroviral therapy and a cervical swab were collected. HPV typing was performed using the Roche Linear Array.
Results
Of 175 participants, 86 (49.1%) were HIV‐positive and had a higher prevalence of low‐risk HPV types (odds ratio [OR] 5.28, P=0.005) compared with HIV‐negative women. The most common high‐risk (HR)‐HPV types in HIV‐positive women were HPV 16 (13.9%) and HPV 18 (11.1%). HIV‐positive women requiring LEEP were more likely to have HR‐HPV types (OR 6.67, P=0.012) and to be infected with multiple HR‐HPV types (OR 7.79, P=0.024) compared to those undergoing cryotherapy.
Conclusion
HIV‐positive women requiring LEEP versus cryotherapy had a higher prevalence of any HR‐HPV type and multiple HR‐HPV types. There were no such differences in HPV types identified among HIV‐negative women.