preprints.org > biology and life sciences > immunology and microbiology > doi: 10.20944/preprints202407.2238.v1 (registering DOI)

Preprint Article Version 1 This version is not peer-reviewed

Version 1 : Received: 26 July 2024 / Approved: 28 July 2024 / Online: 30 July 2024 (09:18:17 CEST)

: Since the identification of acquired immunodeficiency syndrome (AIDS) in 1981, approximately 85.6 million people have been infected with HIV, resulting in 40.4 million deaths. As of 2022, 53% of the 39 million people living with HIV are women and girls. Despite the advent of antiretroviral therapy (ART) improving survival rates, cervical cancer remains prevalent among HIV-infected individuals. By 2030, cervical cancer is projected to cause 727,500 new cases and 432,000 deaths globally. Human papillomavirus (HPV) is a well-known cause of cervical cancer, with HIV infection exacerbating the prevalence of high-risk HPV (HR-HPV) and cervical intraepithelial neoplasia (CIN). HIV and HPV share transmission routes, and HIV worsens cervical carcinogenesis by inhibiting tumour suppressor genes and altering cell cycle regulation. Chronic inflammation and cytokine imbalances, notably increased IL-10 levels, are linked to cervical cancer progression. Despite ART improving overall health, cervical cancer remains a significant issue, highlighting the need for better screening and prevention measures. A cross-sectional study in Brazil evaluated cytokine levels in cervicovaginal lavage among HIV-positive women, revealing a high prevalence of specific HPV types. ART has been shown to reduce the likelihood of developing squamous intraepithelial lesions (SILs) and HR-HPV prevalence, although its impact on invasive cervical cancer remains inconclusive. In a study in Accra, 250 sexually active HIV-positive women exhibited a high HPV prevalence, emphasising the need for regular screening. HPV testing, visual inspection with acetic acid (VIA), and cytology-based tests are primary screening methods, each with specific advantages and limitations. A systematic review and meta-analysis indicated that ART is associated with a lower prevalence of HR-HPV and high-grade cervical lesions, suggesting that early ART initiation may reduce cervical lesion incidence and progression. HPV is a significant cause of sexually transmitted diseases, with high prevalence in sub-Saharan Africa. Studies show a substantial burden of HPV among men in the region, underscoring the potential benefits of HPV vaccination programs. A study in Tanzania highlighted a high prevalence of HR-HPV among HIV-positive men, suggesting the efficacy of HPV vaccines irrespective of HIV status. Cervical cancer rates in sub-Saharan Africa are alarmingly high, necessitating targeted vaccination and prevention strategies.

HIV; HPV; Prevalence; Vaccination strategy; HPV screening; cervical intraepithelial neoplasia

Biology and Life Sciences, Immunology and Microbiology

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