Prevalence and risk factors for High-Risk Human Papillomavirus (hrHPV) infection among HIV-infected and Uninfected Rwandan women: implications for hrHPV-based screening in Rwanda

Infectious Agents and Cancer

Kathryn Anastos³  Howard Strickler¹  Philip E Castle⁴  Brenda Asiimwe-Kateera⁷  Eugene Mutimura¹  Mardge Cohen²  Jean Claude Dusingize¹  Qiuhu Shi⁵  Donald R Hoover⁶  Marc Sklar³  Jean d’Amour Sinayobye¹ 

[1] Regional Alliance for Sustainable Development (RASD), P. O. Box 1544, Kigali, Rwanda;John Stroger (Cook County) Hospital, Chicago, IL, USA;Albert Einstein College of Medicine, Bronx, NY, USA;Global Coalition Against Cervical Cancer, Arlington, VA, USA;NY Medical College, Valhalla, NY, USA;Rutgers University, New Brunswick, NJ, USA;University of Rwanda, College of Medicine and Health Sciences, Butare, Rwanda

关键词: Screening;    Cervical cancer;    HIV;    HPV;   

Others  :  1161146
DOI  :  10.1186/1750-9378-9-40

 received in 2014-08-14, accepted in 2014-11-05,  发布年份 2014

【 摘 要 】

Background

New World Health Organization guidelines recommend high-risk human papillomavirus (hrHPV) screen-and-treat strategies for cervical cancer prevention. We describe risk of, and risk factors for, testing hrHPV positive in a pilot study of hrHPV screen-and-treat conducted in Rwanda.

Methods

A total of 2,964 women, 1,289 HIV-infected (HIV [+]) and 1,675 HIV-uninfected (HIV [-]), aged 30-60 years and living in Rwanda were enrolled in 2010. Cervical specimens were collected and tested by careHPV, a DNA test for a pool of 14 hrHPV types. Prevalence with binomial 95% confidence intervals (95% CI) and determinants of testing hrHPV positive were calculated.

Results

hrHPV prevalence was higher in HIV [+] (31.8%, 95% CI = 29.2-34.4%) than HIV [-] women (8.2%, 95% CI = 6.7-9.8%; P < 0.0001). Among HIV [+] women, there was a significant trend (p_trend <0.001) of higher hrHPV prevalence with lower CD4 cell count, with the highest hrHPV prevalence among those with <200 CD4 cell counts (45.5%, 95% CI = 34.8-56.4%). In multivariate analysis of HIV [+] women, testing hrHPV positive was positively associated CD4 count of <200 cells/μL, history of 3 or more sexual partners, and history of using hormonal contraception, and negatively associated with older age. In HIV [-] women, testing hrHPV positive was negatively associated only with older age groups of 45-49 and 50-60 years and surprisingly was not associated with lifetime number of sexual partners.

Conclusion

hrHPV prevalence is high in HIV [+], especially in women with the lowest CD4 cell counts, which may have implications for utilizing hrHPV-based screening strategies such as screen-and-treat in these high-risk subgroups.

【 授权许可】

   
2014 Sinayobye et al.; licensee BioMed Central.

【 图 表 】

Figure 3.

Figure 2.

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