Human papillomavirus persistence and clearance in women living with HIV : A five‐year retrospective analysis from an Italian university center

INTRODUCTION: Human papillomavirus infection is one of the most prevalent sexually transmitted infections worldwide. Women living with HIV are at increased risk of acquiring and developing persistent infection with high-risk HPV genotypes, leading to higher rates of cervical dysplasia and cancer. However, limited data are available regarding the timing and determinants of HPV clearance in this population. MATERIAL AND METHODS: This is a retrospective, single-center study including women living with HIV with confirmed high-risk HPV infection, followed at an Italian university hospital between 2019 and 2024. Clinical, virological, and immunological data were collected, including HIV viral load, CD4+ T-cell count, and adherence to antiretroviral therapy. HPV persistence, clearance, and time to clearance were assessed over a 5-year follow-up period. Statistical analyses were performed using SPSS version 29, with p < 0.05 considered significant. RESULTS: Seventy-seven women living with HIV were recruited, and fifty-one met the inclusion criteria for analysis. Most participants (92%) were adherent to ART. HR-HPV clearance occurred in 76.5% of patients, with a mean clearance time of 2.08 years. No significant correlation was observed between HPV clearance time and HIV viremia, CD4+ T-cell count, or cytological/colposcopic findings at baseline. However, baseline positivity for the high-risk HPV pool was significantly associated with longer clearance time (p = 0.011). CONCLUSIONS: Women living with HIV showed a high-risk HPV clearance time of approximately 2 years under ART. Our findings suggest that HPV screening every 2 years may represent an appropriate interval in this population, potentially increasing adherence and optimizing healthcare resources. Larger multicenter prospective studies are needed to confirm this observation.