Prevalence, high-risk HPV type profile, and factors associated with high-risk HPV infection among women living with HIV in Kinshasa, Democratic Republic of the Congo

Résumé

Background Cervical cancer is one of the most common cancers in women, particularly among women living with HIV. High-risk human papillomavirus (Hr-HPV) is the main causative agent of this cancer, but the prevalence of Hr-HPV infection among women living with HIV in Kinshasa remains poorly documented. The objective of this study was to determine this prevalence and identify associated risk factors. Methods A cross-sectional study was conducted among women living with HIV aged 25–65 years receiving antiretroviral therapy at the DREAM Center in Kinshasa. Participants were consecutively recruited among eligible women attending the center during the study period. Cervical samples were collected using the Abbott Cervi–Collect kit and analyzed for Hr-HPV genotyping using the Abbott RealTime HPV assay on the m2000 platform, a real-time PCR method detecting HPV-16, HPV-18, and a pooled group of 12 additional high-risk HPV types with an internal β-globin control for sample quality assurance. Sociodemographic and clinical data were collected using structured questionnaires. Results A total of 436 women were included in the analysis. The prevalence of Hr-HPV infection was 47.7%. Of these, 23.79 % were infected with oncogenic HPV-16 and−18 types (alone or in co-infection with other types). In a logistic regression analysis, WHO clinical stage 3 and 4, duration of antiretroviral therapy for less than 2 years, and HIV viral load greater than or equal to 1,000 copies/ml showed statistically significant associations with Hr-HPV infection, with adjusted ORs of 1.75 (1.16–2.64; p = 0.008), 1.91 (1.07–3.41; p = 0.028), and 3.13 (1.30–7.54; p = 0.011), respectively. Conclusions This study reveals a high prevalence of Hr-HPV infection among women living with HIV in Kinshasa. Non-16/18 HPV types were predominant, while HPV-16 and HPV-18 were detected in approximately one in four Hr-HPV-positive women. Advanced HIV disease (WHO clinical stages 3 and 4), unsuppressed HIV viral load, and shorter duration of antiretroviral therapy were independently associated with Hr-HPV infection. These findings underscore the potential value of broader HPV vaccine coverage, including higher-valent vaccines, alongside strengthened cervical cancer screening as part of comprehensive cervical cancer prevention strategies.

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