Association of HIV infection with distribution and viral load of HPV types in Kenya: a survey with 820 female sex workers

Abstract

Background: Human papillomavirus (HPV) and HIV are each responsible for a considerable burden of disease. Interactions between these infections pose substantial public health challenges, especially where HIV prevalence is high and HPV vaccine coverage low. Methods: Between July 2005 and January 2006, a cross-sectional community-based survey in Mombasa, Kenya, enrolled female sex workers using snowball sampling. After interview and a gynaecological examination, blood and cervical cytology samples were taken. Quantitative real-time PCR detected HPV types and viral load measures. Prevalence of high-risk HPV was compared between HIV-infected and -uninfected women, and in women with abnormal cervical cytology, measured using conventional Pap smears. Results: Median age of the 820 participants was 28 years (inter-quartile range (IQR) = 24-36 years). One third of women were HIV-infected (283/803; 35.2%) and these women were more likely to have abnormal cervical cytology than HIV-negative women (27%, 73/269, versus 8%, 42/503; P