1564. Prevalence, Management and Outcomes of Human Papillomavirus (HPV)-Related Cervical and/or Anal Lesions in a Cohort of Perinatally and Behaviorally HIV-Infected Women
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDWeek poster 20115 Abadi-HPV.pdf (842.7 kB)
  • Background:

    The natural history of Human Papillomavirus (HPV) in Human Immunodeficiency Virus (HIV)-infected individuals differs from that of immune competent hosts. Specifically, spontaneous rate of clearance of HPV may be affected by presence of HIV-coinfection and the degree of HIV-related immunosuppression. We conducted a retrospective chart review of cervico-vaginal and anal Papanicolaou smear (Pap) results and clinical correlates in a population of HIV-infected women followed in our inner city medical center. 

    Methods:

    Records of 185 HIV-infected women were available for review. Of those, 167 were behaviorally infected (BI) and 18 acquired their HIV through perinatal transmission (PT). Demographic, immunologic and virologic parameters at the time of the Pap were recorded. Abnormal Pap included low and high grade squamous intraepithelial lesions and ASCUS. Colposcopic and high resolution anoscopy (HRA) results and patient outcomes were documented. HPV typing was available for some but not all samples.

    Results:

    The median age of the cohort was 40 years (16-62 years). In the PT cohort there were 11 anal and 12 vaginal abnormal Pap. In the BH women cohort there were 143 anal and 124 vaginal abnormal Pap. Among the patients with abnormal Pap results, 55 had abnormal findings that were persistent. All but 4 of those 55 patients underwent colposcopy and/or HRA. 18 of the 55 patients required further ablative and/or colorectal corrective surgery. Severity of disease and need for surgery correlated with degree of immune suppression and worse virologic control. Age and mode of HIV transmission was not found to be a correlate of severity. 

    Conclusion:

    High degree of HPV disease severity was found in a cohort of women who were both behaviorally and perinatally HIV-infected. This points to the need for aggressive preventive screening and treatment strategies.

    Joana Dobroszycki, M.D.1, Adam Kohutnicki, BA candidate2, Marianne Hennessy, NP3, Michael Rosenberg, M.D. Ph.D4, Jorge Sansary, M.D.5 and Jacobo Abadi, M.D.1, (1)Pediatrics/HIV, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, (2)Pediatrics, Jacobi Medical Center, Bronx, NY, (3)Internal Medicine, Jacobi Medical Center, Bronx, NY, (4)Pediatrics/HIV, Jacobi Medical Center/Albert EInstein College of Medicine, Bronx, NY, (5)HIV, Jacobi Medical Center, Bronx, NY

    Disclosures:

    J. Dobroszycki, None

    A. Kohutnicki, None

    M. Hennessy, None

    M. Rosenberg, None

    J. Sansary, None

    J. Abadi, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.