Diverse and High Prevalence of Human Papillomavirus Associated with a Significant High Rate of Cervical Dysplasia in Human Immunodeficiency Virus-Infected Women in Johannesburg, South Africa

Objective To evalute the epidemiology of the human papillomavirus (HPV) type and correlate it with the Papanicolaou smears in human immunodeficiency virus-seropositive women in Johannesburg, South Africa. Study Design In a cohort of 148 women, HPV DNA testing was performed with the Roche HPV genotying test (Branchburg, New Jersey, U.S.A). Papaniolaou smears were performed by standard cytology utilizing 2001 Bethesda reporting guidelines. Results The average age and CD4 count of the participants wits 35 years and 255 cells per mm(3), respectively. Fifity-four percent had abnormal Papanicolaou smears; 66% of the abnormal cytology was low grade changes, with 33% assessed as having high grade changes. HPV DNA was found in 95% of the 148 subjects assessed, with 83% having I or more HPV oncogenic types. Common oncogenic types were 16, 35, 53 and 18. When HPV results were stratified by CD4, there was a significant risk of an oncogenic HPV type in women with CD4 < 200. Significant odds ratios for high grade lesions were seen in HPV types 16, 35, 51, 66, 69 and 73. Conclusion The results of HPV tying illustrate the diverse range of oncogenic HPV and high prevalence of oncogenic type. These results highlight the need for improved access to Papanicolaou smear screening for this population. (Acta Cytol 2009;53:10-17)