WCMC Student Presents HPV Research at Boston Conference

The team: Charles, Katharine, Carole, and Dr. BienAime at GHESKIO

Katharine Boyle (MD'12) presented a poster at the Conference on Retroviruses and Opportunistic Infections in Boston, Massachusetts this past week. She was awarded a Young Investigator Award for research she conducted on cervical HPV and dysplasia in HIV infected women in collaboration with investigators from the GHESKIO Center in Haiti in 2008-2009.

Cervical cancer is causally linked to human papilloma virus (HPV) infection and is a leading cause of death in HIV positive women in resource poor settings. There are few data available on the prevalence of HPV or of high-grade cervical lesions among HIV positive women in these settings. She sought to determine the prevalence of high-risk HPV and high-grade cervical lesions among HIV positive women in Port au Prince, Haiti.

She screened HIV-infected women in Port au Prince for cervical HPV and dysplasia- the presence of abnormal cells which sometimes are precursors to cancer, and reported the number of women with a high-risk HPV cervical infection and women with high-grade lesions on cytology and histology (Pap test with HSIL or biopsy with CIN2, CIN3, or cancer).

A total of 422 HIV-infected women with median age of 41 and median CD4 count of 312 cell/mm3 were screened. Of the 422 women screened, 260 (62%) had infection with a high-risk HPV. 98 (23%) had low-grade squamous intraepithelial lesions (LSIL), 30 (7%) had high-grade squamous intraepithelial lesions (HSIL) and two had invasive carcinoma. Biopsy and Pap results showed that a total of 46 (11%) patients had high-grade cervical lesions.

Ms. Boyle's study documents the high prevalence of HIV and HPV co-infection in Port au Prince, posing a major risk to patients who present to HIV clinics for treatment. The results of this study underscore the need for cervical cancer screening for HIV-infected women in underresourced settings. The findings have already prompted the GHESKIO clinic and the Haitian Ministry of Health to begin a screening program for HIV infected women in Haiti. Ms. Boyle plans to return to Haiti during the summer of 2011 to continue to build her research skills with collaborators at GHESKIO.