Unveiling the interplay of cervical erosion, leucorrhea, and HPV coinfection in the development of abnormal cervical lesion among HIV-positive women

¹ Department of Anatomical Pathology, Faculty of Medicine and Health Science, Universitas Warmadewa, Indonesia
² Faculty of Medicine and Health Science, Universitas Warmadewa, Indonesia
³ Department of Biochemistry, Faculty of Medicine and Health Science, Universitas Warmadewa, Indonesia
⁴ Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA

Abstract

Cervical cancer is a one of significant malignancy in women, especially in developing country. High-risk HPV (hr-HPV) infection is the leading cause of cervical cancer. This study provides novel insight by analyzing the combined effect of cervical erosion, leukorrhea, HPV infection (both low and high-risk), and their co-infection on the risk of developing atypical cervical epithelial lesions (ASCUS+) in HIV+ women. A population at heightened oncogenic risk due to immunosuppression. This study uniquely quantifies how these clinical and virological factors interact to influence abnormal cervical pathology in HIV+ population. A cross-sectional study of 130 HIV+ women from Bali VCT clinics included cytological cervical screening (Bethesda system), HPV genotyping, and clinical assessment for cervical errosion and leukorrhea. The results showed that 75.4% of samples had portio erosion, 30.8% had leukorrhea, 16.9% had low-risk HPV, 51.5% had hr-HPV, and 12.3% had both. Statistical study indicates significant relationship between portio erosion, hr-HPV infection, and ASCUS+ HPV coinfection (p <0.05). The findings support integrated cervical screening with targeted HPV testing and clinical assessment of cervical erosion in HIV+ populations. Future studies should utilize multi-center designs and consider additional confounders to further clarify causal mechanisms and optimal screening strategies.