Evidence of a higher prevalence of HPV infection in HTLV-1-infected women compared to uninfected women

Abstract

Background: It is estimated that 50.000 individuals (2%) are currently infected with HTLV-1 in Salvador-Bahia, Brazil. This infection is more frequent among women. HPV, another sexually transmitted disease, causes cervical cancer, specially in immunossupressed individuals. HTLV-1 infected individuals are more susceptible to several infectious diseases, but few studies addresses the co-infection between HPV/HTLV-1. Aim: To determine the prevalence of HPV infection in HTLV-1-infected patients. Methods: An outpatient cross-sectional study was carried out between September 2005 toDecember 2008. This study involved 50 HTLV-1-infected women from the Reference Center of HTLV (ELISA+Western Blot) and 40 uninfected from the gynecology clinic, at Bahian School ofMedicine. HPV infection was assessed by hybrid capture. HTLV proviral load was quantified by Real time PCR and CD4T lymphocytes by flow cytometry. Results: The mean age of HTLV-1-infected women (38±10 yrs) was similar to that of controls (36±13 yrs). There were no differences in schooling, marital status, or smoking habits between the groups HTLV infected and uninfected. However, the mean age of first sexual intercourse of HTLV-1-infected women (17±3 yrs) was lower than HTLV-1 uninfected (19±3 yrs) (p=0.03), conversely the number of sexual lifetime partners was greater in HTLV-1 infected (4±3 yrs) compared to uninfected group (2±1) (p<0.01). The prevalence of HPV infection was 44% in the group HTLV-1-infected, while this proportion was only 22.5% in the uninfected women (p=0.03). There was no difference in the frequency of high (group B) and low (group A) risk HPV subtypes between HTLV-1-infected and uninfected groups. Moreover, in the HTLV-1-infected group there was no association between HPV infection and CD4 T cell count or HTLV-1-proviral load. Conclusion: The prevalence of HPV infection is higher in HTLV infected women. Gynecological evaluation and HPV screening should be considered essential part of the assessment of HTLV-1-infected woman.