Confronting the human papillomavirus–HIV intersection: Cervical cytology implications for Kenyan women living with HIV

Southern African Journal of HIV Medicine

Field Value
Title Confronting the human papillomavirus–HIV intersection: Cervical cytology implications for Kenyan women living with HIV
Creator Kangethe, James M. Gichuhi, Stephen Odari, Eddy Pintye, Jillian Mutai, Kenneth Abdullahi, Leila Maiyo, Alex Mureithi, Marianne W.
Subject — high-risk human papillomavirus; cervical cytology; cervical cancer; women living with HIV; antiretroviral therapy; Kenya
Description Background: High-risk human papillomavirus (HR-HPV) is the primary cause of cervical cancer, leading to over 311 000 global deaths, mainly in low- and middle-income countries. Kenyan women living with HIV (WLHIV) face a disproportionate burden of HR-HPV.Objectives: We determined the prevalence of HR-HPV infections and their association with cervical cytology findings among Kenyan WLHIV.Method: We conducted a cross-sectional study among WLHIV attending the HIV care and treatment clinic at the Kenyatta National Hospital (KNH), Kenya’s national referral hospital. Study nurses collected a cervical sample with a cytobrush for HR-HPV genotyping using Gene Xpert® assays and HPV Genotypes 14 Real-TM Quant V67-100FRT. Bivariate analysis explored the associations.Results: We enrolled 647 WLHIV (mean age of 42.8 years), with 97.2% on antiretroviral therapy (ART) and 79% with a suppressed viral load ( 50 copies/mL plasma). The prevalence of any and vaccine-preventable HR-HPV was 34.6% and 29.4%, respectively, with HPV 52 being the most common genotype (13.4%). Among WLHIV with HR-HPV infections, 21.4% had abnormal cervical cytology. Women with multiple HR-HPV infections were more likely to have abnormal cytology compared to those with single HR-HPV infections (34.9 vs 9.3%, adjusted odds ratio [aOR] = 6.2, 95% confidence interval [CI]: 2.7–14.1, P = 0.001). Women with HR-HPV infection (single or multiple) were more likely to be on the second-line ART regimen compared to those without HR-HPV infections (53.1% vs 46.7%, aOR = 2.3, 95% CI: 1.3–4.1, P = 0.005).Conclusion: Among WLHIV at KNH, abnormal cytology was common and more frequent among women with multiple HR-HPV infections.
Publisher AOSIS
Date 2023-10-27
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v24i1.1508
Source Southern African Journal of HIV Medicine; Vol 24, No 1 (2023); 12 pages 2078-6751 1608-9693
Language eng
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Rights Copyright (c) 2023 James Mburu Kangethe, Stephen Gichuhi, Eddy Odari, Jillian Pintye, Kenneth Mutai, Leila Abdullahi, Alex Maiyo, Marianne W. Mureithi