Abstract

 Background: Globally, 500,000 new cases of cancer of the uterine cervix are recorded annually, nearly 20% are from India. Numerous clinical and experimental studies have established an association between HPV and cervical cancer. Most immune responses are important in resolution of HPV infection; hence, women with HIV are more likely to have severe, frequent HPV disease. Considering the increasing incidence of HIV in India, an increase in cervical abnormalities and cervical cancer can be expected in the near future. This study was thus carried out to study the prevalence and association of HPV and HIV co-infection in women with precancerous and cancerous lesions of cervix. Design: Cross-sectional study.

Aims: To study the prevalence and correlation of HPV and HIV infection in women with cervical intraepithelial neoplasia and cervical cancer. Materials and methods: Sexually active women attending the Gynecology OPD and IPD with sign and symptoms suggestive of cervical pathology were subjected to cytology, colposcopy, and biopsy. Cervical samples for HPV detection and blood samples for HIV detection were taken.

Statistical analysis: Chi-square test for statistical significance.

Results: 254 women were enrolled based on signs and symptoms.143 women returned for follow-up. 129 were subjected to cervical biopsy and HPV testing of cervical tissue. HPV positivity in low-grade squamous intra-epithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL) and cervical cancer was 60%, 100% and 93.1% respectively. None of the women tested were reactive for HIV.

Conclusion: For early detection and identification of high-risk population with precancerous lesions, there is a need for incorporation of HPV testing along with cytology to screen women. In view of the spreading HIV infection in India, we need to increase surveillance for HIV positive cases and increase awareness regarding prevention of HIV infection.