Human papillomavirus prevalence in pregnant women living with human immunodeficiency virus infection: a scoping review of the literature

Author:

Metz Charlotte Kalinka1,Skof Anna Sophie2,Henrich Wolfgang1,Sehouli Jalid23,Kaufmann Andreas M.2,Rohr Irena1

Affiliation:

1. Department of Obstetrics , Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin , Berlin , Germany

2. Laboratory for Gynaecological Tumorimmunology , Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin , Berlin , Germany

3. Department of Gynecology with Center for Oncological Surgery , Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt – Universität zu Berlin , Berlin , Germany

Abstract

Abstract Objectives Studies already pointed out the increased risk of human papillomavirus (HPV) positivity and the implied risk of cervical dysplasia and even cervical carcinoma in pregnant women with human immunodeficiency virus (HIV) infection. Nevertheless, due to less data there is still no standardised and expanded screening for this high-risk group. Content Two online databases (PubMed, EMBASE) were used to identify eligible studies. Results are shown in percentages. Wherever useful the arithmetic mean was calculated. Summary Seven studies were included. Pregnant WLWH showed HPV prevalence between 34 and 98.4 %. Different sensitivity and specificity among PCR methods for HPV detection could be a reason for the large range concerning HPV prevalence. Risk factors like Age, Smoking, Sexuality, HIV status and education level should always be taken into account. Association between HPV prevalence and level of CD4 cells or HIV virus load was seen. In which way use of Antiretroviral Therapy (ART) could decries the risk for HPV infections is still discussed. When cytology was performed only few high-grade squamous intraepithelial lesion (HSIL) were found. Outlook Standardisation and expansion of preventive screening for cervical dysplasia and carcinoma for pregnant WLWH is necessary. Then better comparability of the data will also be achieved.

Publisher

Walter de Gruyter GmbH

Subject

Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health

Reference28 articles.

1. World Health Organisation (WHO). HIV, Estimated percentage of pregnant women living with HIV who received antiretrovirals for preventing mother-to-child transmission 2022. https://www.who.int/data/gho/data/indicators/indicator-details/GHO/estimated-percentage-of-pregnant-women-living-with-hiv-who-received-antiretrovirals-for-preventing-mother-to-child-transmission [Accessed 24 Apr 2023].

2. AWMF LO. S3-Leitlinie Prävention des Zervixkarzinoms; 2020. March 2020. https://www.awmf.org/uploads/tx_szleitlinien/015-027OLl_Praevention_Zervixkarzinom_2020-03-verlaengert.pdf [Accessed 24 Apr 2023].

3. World Health Organisation (WHO). WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, second edition: use of mRNA tests for human papillomavirus (HPV) 2021. https://www.who.int/publications/i/item/9789240040434 [Accessed 24 Apr 2023].

4. Filippidis, P, Francini, K, Jacot-Guillarmod, M, Mathevet, P, Lhopitallier, L, Cavassini, M, et al.. HIV testing in termination of pregnancy and colposcopy services: a scoping review. Sex Transm Infect 2022;98:143–9. https://doi.org/10.1136/sextrans-2021-055111.

5. Metz, CK, Skof, AS, Sehouli, J, Siedentopf, JP, Gebert, P, Weiss, F, et al.. Assessment of high-risk human papillomavirus infections and associated cervical dysplasia in HIV-positive pregnant women in Germany: a prospective cross-sectional two-centre study. Arch Gynecol Obstet 2022;308:207–18. https://doi.org/10.1007/s00404-022-06890-w.

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