Prevalence of cervical human papillomavirus infections and cytological abnormalities in asymptomatic women living with HIV in Addis Ababa, Ethiopia

Abstract

Cervical cancer from persistent HPV infection is the leading cause of cancer death among Sub-Saharan African women. We here addressed the existing knowledge gap concerning the prevalence of HPV infection and cervical lesions in asymptomatic women living with HIV (WLWH) in Addis Ababa, Ethiopia. Adult WLWH (N = 334) were recruited at the HIV clinic of the Tikur Anbessa Specialized Hospital, Addis Ababa. Real-time PCR targeting 12 high-risk (HR) and 2 low-risk HPV types on cervical samples and Pap smear testing were performed. Logistic regression was used in IBM SPSS Statistics to identify factors associated with HPV infection and abnormal cytology. HR-HPV infections occurred in 20.6% of participants and the most prevalent HR-HPV genotypes were HPV35 (16.8%) and HPV16 (14.7%). Abnormal cytology was more common among HR-HPV-positive women than HR-HPV-negative women (36.1% vs. 12.6%, p < 0.0001). LSIL and HSIL were detected in 9.9% and 6.6% of HR-HPV-positive women, respectively. Condom use was associated with reduced odds of HPV infection and abnormal cytology. HR-HPV infections dominated by non-HPV16/18 types and abnormal cytology were common among asymptomatic WLWH in Ethiopia underscoring the need for strengthened cervical cancer screening, HPV vaccinations and safe-sex education for this high-risk population.