Estudo clínicopatológico e análise molecular do papilomavírus humano de alto risco em região cervical e mucosa oral de mulheres hiv/aids e hiv negativas.

Abstract

Human immunodeficiency virus (HIV) is responsible for high mortality rates worldwide. HIV infection predisposes coinfections, such as human papillomavirus (HPV). HPV is the most common viral infection on the globe with high-risk subtypes associated with various neoplastic processes, such as in the cervix and, more recently, in the oral cavity. Females are distinguished by the vulnerability to exposure of these infections. The objective of the present study is to evaluate the clinical and molecular profile of high-risk HPV in the cervix-uterine region and oral mucosa of HIV/AIDS and HIV-negative women. This is a prospective, crosssectional quantitative study, in which 76 women from two health services were evaluated in Fortaleza, Ceará, Brazil. The sample was divided into two groups: the first group consisting of women with prior diagnosis of cervical HPV-compatible lesion (group 1), and the second with a previous diagnosis of HIV/AIDS infection (group 2). In both groups, sexual behavior, cervical oncology cytology and molecular analysis of HPV were analyzed by real-time PCR of the oral and cervical mucosa through the Cobas® 4800 system. Data were expressed as absolute frequency and percentage and compared by Pearson exact Fisher or Chi-square test. The analyzes were performed in the Statistical Packing for Social Sciences (SPSS) software, adopting a confidence of 95%. In the results, HIV/AIDS patients are included in a precarious social situation of low schooling (p<0.001), unemployment (p=0.002), alcohol exposure (p=0.002) and illicit drugs (p=0.033); (p=0.003) during sexual intercourse, they are related to seropositive partners (p<0.001), although they discontinued their sexual activity early (p=0.04). The cytopathological test was suggestive of HPV infection in 10.5% of the women. The prevalence of high-risk HPV in the cervico-uterine region was 26.3% in all participants, with a higher risk for HIV/AIDS women (p=0.02). Normal oral mucosa was negative for high-risk HPV in all participants. Therefore, the need for greater attention to women with HIV is emphasized, due to the socioeconomic context and the risk of coinfections. Cervical cytology associated with molecular tests, such as Cobas® 4800, are important in the prevention of cervical cancer in this group of patients.