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 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.
Yx et al. (Tue,) studied this question.