Prevalence and factors associated with high-risk oncogenic human papillomavirus infection among women living with HIV in Kinshasa, the Democratic Republic of the Congo

Abstract

Abstract Background Cervical cancer is one of the most common cancers in women, particularly among women living with HIV (WLWH). Persistent infection with High-risk oncogenic human papillomavirus (Hr-HPV) is the primary etiological factor. However, data on Hr-HPV prevalence among WLWH in Kinshasa, Democratic Republic of the Congo, remains poorly documented. This study aimed to determine the prevalence of Hr-HPV infection and identify associated risk factors in this population. Methods A cross-sectional study was conducted on WLWH aged 25 to 65 years receiving antiretroviral therapy at the DREAM Centre in Kinshasa. Cervical sample were collected and analysing using multiplex PCR for detection of Hr-HPV genotypes. Sociodemographic data and risk factors were collected via questionnaires, and associations with Hr-HPV infection were assessed using multivariate logistic regression. Results A total of 436 women were included. The prevalence of Hr-HPV infection was 47.25%. HPV types 16 and 18 (alone or in co-infection) were detected in 23.79% of participants. In a multivariate logistic regression analysis, WHO clinical stage 3–4 (aOR 1.75; 95% CI 1.16–2.64; p=0.008) and HIV viral load ≥1000 copies/mL (aOR 3.08; 95% CI 1.28–7.42; p=0.012) and Antiretroviral therapy duration <2 years (aOR 0.52; 95% CI 0.29–0.93; p=0.028) were significantly associated with Hr-HPV infection. Conclusions Nearly one in two WLWH in Kinshasa was infected with Hr-HPV, and one in four carried HPV-16/18 genotypes. Advanced HIV disease and uncontrolled viral replication were strongly associated with Hr-HPV infection. These findings underscore the urgent need to integrate systematic Hr-HPV screening into HIV care programs, particularly for women with advanced clinical stage or persistent viremia.