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Background <p>Human papillomavirus (HPV) and human immunodeficiency virus (HIV) co-infection exerts a substantial impact on women’s health globally. This study enrolled confirmed HPV-infected women in Shanghai stratified by HIV status to compare the profiles of HPV genotype distribution and cervical lesions between two groups, and to identify the risk factors for cervical dysplasia among women with HIV-HPV co-infection.</p> Methods <p>A total of 238 confirmed HPV-infected women who attended the Shanghai Public Health Clinical Center between January 2019 and July 2023 were enrolled in this cross-sectional study. All participants were divided into HIV-positive and HIV-negative groups. We compared the pathological distribution characteristics, high/low-risk HPV infection patterns and cervical cytological abnormalities between the two groups. Multivariate logistic regression was used to explore risk factors for cervical dysplasia in HIV-HPV co-infected women.</p> Results <p>Among the 238 HPV-positive patients, 47.9% (114/238) were HIV-HPV co-infected. The top five predominant HPV genotypes were HPV16, HPV52, HPV58, HPV53, and HPV18. The HIV-positive group had significantly higher rates of HR-HPV infection (χ²=4.537, <i>p</i> = 0.037) and multiple HR-HPV infections (χ²=15.878, <i>p</i> &lt; 0.001) than the HIV-negative group. HPV33 and HPV66 were more prevalent in the HIV-positive group, and the positivity rates of HPV genotypes covered by 2-valent, 4-valent, and 9-valent HPV vaccines were all significantly higher in the HIV-positive group than in the HIV-negative group. HPV52 and HPV58 (13.10%, 11/84) were the most common genotypes in multiple HPV infections. The HIV-positive group had a significantly higher rate of cytological abnormalities (χ²=11.658, <i>p</i> &lt; 0.001). Multivariate logistic regression analysis indicated that HIV RNA load &gt; 1000 copies/µl was an independent risk factor (OR 9.845, 95%CI 1.324–73.202, <i>p</i> = 0.026) for cervical dysplasia in the HIV-positive group.</p> Conclusions <p>Within the HPV-positive female population, HIV-positive women exhibit higher burdens of multiple HPV infection and cervical cytological abnormalities. Elevated HIV RNA load is a key independent risk factor for cervical dysplasia in this co-infected population. Immediate initiation of antiretroviral therapy, prioritized 9-valent HPV vaccination, and regular cervical cancer screening are recommended to reduce the risk of cervical lesions and alleviate the disease burden among HIV-HPV co-infected women.</p>

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HPV genotype distribution and risk factors for cervical dysplasia among HPV-positive women with or without HIV infection in Shanghai, China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月23日

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  • Yuxi Ma,
  • Min Liu

摘要

Background

Human papillomavirus (HPV) and human immunodeficiency virus (HIV) co-infection exerts a substantial impact on women’s health globally. This study enrolled confirmed HPV-infected women in Shanghai stratified by HIV status to compare the profiles of HPV genotype distribution and cervical lesions between two groups, and to identify the risk factors for cervical dysplasia among women with HIV-HPV co-infection.

Methods

A total of 238 confirmed HPV-infected women who attended the Shanghai Public Health Clinical Center between January 2019 and July 2023 were enrolled in this cross-sectional study. All participants were divided into HIV-positive and HIV-negative groups. We compared the pathological distribution characteristics, high/low-risk HPV infection patterns and cervical cytological abnormalities between the two groups. Multivariate logistic regression was used to explore risk factors for cervical dysplasia in HIV-HPV co-infected women.

Results

Among the 238 HPV-positive patients, 47.9% (114/238) were HIV-HPV co-infected. The top five predominant HPV genotypes were HPV16, HPV52, HPV58, HPV53, and HPV18. The HIV-positive group had significantly higher rates of HR-HPV infection (χ²=4.537, p = 0.037) and multiple HR-HPV infections (χ²=15.878, p < 0.001) than the HIV-negative group. HPV33 and HPV66 were more prevalent in the HIV-positive group, and the positivity rates of HPV genotypes covered by 2-valent, 4-valent, and 9-valent HPV vaccines were all significantly higher in the HIV-positive group than in the HIV-negative group. HPV52 and HPV58 (13.10%, 11/84) were the most common genotypes in multiple HPV infections. The HIV-positive group had a significantly higher rate of cytological abnormalities (χ²=11.658, p < 0.001). Multivariate logistic regression analysis indicated that HIV RNA load > 1000 copies/µl was an independent risk factor (OR 9.845, 95%CI 1.324–73.202, p = 0.026) for cervical dysplasia in the HIV-positive group.

Conclusions

Within the HPV-positive female population, HIV-positive women exhibit higher burdens of multiple HPV infection and cervical cytological abnormalities. Elevated HIV RNA load is a key independent risk factor for cervical dysplasia in this co-infected population. Immediate initiation of antiretroviral therapy, prioritized 9-valent HPV vaccination, and regular cervical cancer screening are recommended to reduce the risk of cervical lesions and alleviate the disease burden among HIV-HPV co-infected women.