Sérotypes de Papillomavirus Humain à Haut Risque chez les Patientes Séropositives au VIH Présentant des Lésions Intra Épithéliales Cervicales

ABSTRACT INTRODUCTION. Many studies have showed a high risk of HPV persistence and the development of cervical cancer among immuno deficient patients. In the aim to determine serotypes of human papilloma virus (HPV) of high risk among HIV infected women with cervical intra epithelial lesions, we conducted a prospective and analytic the study at Medical Diagnostic center and in Centre Pasteur of Yaounde. METHODOLOGY. We carried out a prospective and analytic study which took 9 months. The study included 112 HIV sexually active infected women. Data of interest were the type of cervical epithelial lesions lesion and its grade and risk factors. RESULTS. The average age was 38,5 years. 66% of the smear tests were inflammatory and 21% were dysplastic. 71% of the dysplastic lesions were of high grade. In this high grade group, the HPV testing was always negative. The only significant risk factor was the low CD4 count. CONCLUSION. In Cameroonian HIV infected women, high grade intra epithelial lesions are associated with HPV serotypes that are not highly aggressive, and that therefore can be missed by the ABOOT test. RESUME INTRODUCTION. De nombreuses etudes ont montre un risque eleve de persistance du HPV et de developpement du cancer du col chez les patientes immunodeprimees Dans le but de determiner les Serotypes HPV a haut risque parmi les femmes seropositives au HIV ayant des lesions intra epitheliales, nous avons entrepris une etude prospective et analytique au laboratoire Medical center et au Centre Pasteur de Yaounde. METHODOLOGIE. Il s`agit d`une etude prospective et analytique qui s`est etalee sur 9 mois. Nous avons inclus 112 patientes seropositives, actives sexuellement. Les variables etudiees etaient le type de lesion et le grade ainsi que les facteurs de risques. RESULTATS. L`âge moyen des patientes etait de 38,5 ans. 66% des frottis etaient inflammatoires ( 66%) et 21% etaient dysplasiques. Chez les 21 patientes ayant une dysplasie cervicale, 15 (71%) presentaient une dysplasie de haut grade H-SIL. Dans ce groupe, le test HPV a ete constamment negatif, et le seul facteur de risque significatif etait le taux bas de CD4. CONCLUSION. Chez les patientes HIV positives, les lesions de haut grade sont dues a des Serotypes HPV peu agressifs, donc non visualises par le test ABOOTT qui ne detecte que les Serotypes a haut risque.