ASPO Abstracts
Prevalence of high-risk HPV infection among HIV-infected women undergoing cervical cancer screening in Mysore, India.
Category: Global Cancer Research
Conference Year: 2020
Abstract Body:
Purpose of the Study: Cervical cancer is an AIDS-defining illness and some studies suggest
it may be the most common HIV-related malignancy in women. India, with 2.1 million people
living with HIV, has the third largest HIV epidemic in the world. About 40% of infections are
among women and research suggests they are four to five times more likely to develop
invasive cervical cancer compared to the general population. Studies examining the
prevalence of high-risk HPV (HrHPV) in HIV-infected Indian women found that it ranged from
about 20% in Chandigarh to 46.2% in West Bengal. There is little data on HrHPV prevalence
among HIV-infected women living in Karnataka, one of the six HIV/AIDS high prevalence
states in India. We assessed the burden of high-risk HPV and pre-cancerous lesions among
HIV-infected women in Mysore, the second largest city in Karnataka.
Methods: Between January and June of 2017, 160 HIV-infected women underwent a pelvic
examination along with Visual Inspection using Acetic Acid (VIA) as part of a community-
based cervical cancer screening program. A vaginal swab was taken for HPV testing using
the Digene Hybrid Capture 2 Assay to detect 13 HrHPV types (Qiagen, US). If participants
expressed interest in participating in the study they underwent an informed consent process
and an interviewer-administered questionnaire in Kannada. On receipt of a positive VIA test,
women were referred for a free Pap smear.
Results: Of the 160 HIV-infected women, 139 elected to participate in the study. Among
those, 43.2% (n=60) were found positive for HrHPV. HrHPV positive women were more
likely to be younger, married, Hindu, and housewives. About 40% had no education, 25%
had a primary education and 35%, secondary education and above. Ten women (16.6%)
had squamous intraepithelial lesions (LSIL & HSIL) or atypical glandular cells (AGU) based
on PAP smears. Of the 10 PAP positive women, 5 had HSIL, 3 had AGU, and 2 had LSIL.
Conclusion: The study suggests a high burden of HrHPV infection and cervical dysplasia
among HIV-infected women in Karnataka. There is a compelling need for cervical cancer
screening and treatment in this high-risk population.
Keywords: Cervical cancer; Cancer Screening; HIV; HPV; India