Detection of types of HPV among HIV‐infected and HIV‐uninfected Kenyan women undergoing cryotherapy or loop electrosurgical excision procedure

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.