PREVALÊNCIA DE INFECÇÃO POR HPV DE ALTO RISCO ONCOGÊNICO E LESÕES CERVICAIS EM MULHERES PRIVADAS DE LIBERDADE

Abstract

Human papillomavirus (HPV) is a globally prevalent sexually transmitted infectious agent. Although sexual contact represents the primary route of transmission, HPV may also be transmitted through direct skin-to-skin, skin-to-mucosa, or mucosa-to-mucosa contact. More than 400 HPV types have been identified, of which only a subset are capable of infecting the anogenital tract. Based on oncogenic potential, HPV is classified as either low-risk (LR-HPV) or high-risk (HR-HPV). Persistent infection with HR-HPV types constitutes the principal etiological factor in the development of precursor lesions that may progress to cervical cancer, particularly when persistence coexists with biological, social, and behavioral risk factors. Cervical cancer is characterized by a slow progression, which facilitates early screening and diagnosis. Women deprived of liberty represent a population at heightened risk of HPV infection and, consequently, cervical neoplasia. The present study aimed to assess the prevalence of high-risk HPV infection and cervical lesions among incarcerated women. This cross-sectional, quantitative study was conducted between October and November 2023 in the women’s penitentiaries of Campo Grande and Três Lagoas, located in the state of Mato Grosso do Sul, Brazil. A total of 141 incarcerated women were interviewed, and cervical cell samples were subsequently collected. Liquid-based cytology samples were processed using TPK-Fênix (Kolplast®) equipment, and HPV DNA detection and genotyping were performed using the Cobas HPV Test® (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Data were stored on the REDCap (Research Electronic Data Capture) platform and later exported for statistical analysis in R software (version 4.4.0). Descriptive analyses of categorical and continuous variables were conducted, with results presented as absolute and relative frequencies. Associations between variables were examined using the chi-square test or Fisher’s exact test, as appropriate, with statistical significance defined as p < 0.05. Results were expressed as odds ratios (OR) and 95% confidence intervals (95% CI). The prevalence of cytological abnormalities was 44.7% (95% CI: 36.5%–52.9%), while the prevalence of HR-HPV infection was 23.4% (95% CI: 16.4%–30.4%). The presence of other microorganisms (OR = 3.16; 95% CI: 1.22–8.11) and HR-HPV positivity (OR = 5.03; 95% CI: 3.68–8.82) were independently associated with cytological alterations. These findings indicate that incarcerated women exhibit a substantially higher prevalence of HR-HPV infection and pre-neoplastic cervical lesions compared with women in the general population. Given the distinct epidemiological profile of this population, they are more susceptible to HR-HPV infection and its related outcomes. The results underscore the urgent need to strengthen and implement comprehensive measures for screening, prevention, treatment, and follow-up, with the objective of reducing HPV-related disease burden in this vulnerable group.