Prevalence of Bacterial Vaginosis and High Risk HPV Co-Infection among HIV-Positive Women at Machakos Level-5 Hospital, Machakos County, Kenya

Abstract

Background: Cervical cancer is a huge health burden globally. Precancerous cervical lesions, if not diagnosed and treated early enough, could become cervical cancer. HIV-positive women are among the highly susceptible individuals to both bacterial vaginosis and cervical cancer due to their compromised immune systems. In Kenya, cancer of the cervix is the second most common type of cancer among women. HIV Infected women have a high prevalence of HPV infection and associated cervical lesions. The Human Papilloma Virus (HPV) sub types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59 are attributed to causing cervical cancer, with subtypes16 and 18 being the most common. Bacterial vaginosis is a type of bacterial inflammation due to an imbalance of harmful and beneficial bacteria in the vagina. Women with bacterial vaginosis infection could easily acquire HIV, among other sexually transmitted infections. This is because bacterial vaginosis infection leads to disruption of the normal vaginal micro flora, which results in increased vaginal PH. This, therefore, results in the recruitment of the immune cells to the HIV infection target cells. Objective: The study aimed to determine the prevalence of bacterial vaginosis and high-risk HPV co-infection among HIV-positive women at Machakos Level-5 Hospital in the Comprehensive Care Clinic. Study Design: The study used a prospective cross-sectional design. Place and Duration of Study: Comprehensive Care Clinic (CCC), Machakos Level 5 Hospital, between July and October 2023. Methodology: The study included 125 HIV-positive women aged 21 to 64 years who consented to take part in the study. The participants were screened for high-risk HPV sub types using real-time PCR and for cervical lesions and bacterial vaginosis through microscopic examination of pap smears. Results: 125 HIV-positive women aged between 21 and 64 years were included in the study. Out of the 125 study participants, 36 tested positive (28.8%) for various HPV sub types. 13(10.4%) study participants out of the 125 tested positive for bacterial vaginosis. 11(8.8%) study participants had bacterial vaginosis and HPV co-infection. Conclusion: The prevalence of bacterial vaginosis and HPV co-infection among HIV-positive women at Machakos Level 5 Hospital is 8.8%. Of all the risk factors analyzed, only method of contraceptive used was found to have a significant association with bacterial vaginosis and HPV co-infection (P = .002).