Clustering patterns of human papillomavirus infections among HIV-positive women in Kenya

Infectious Agents and Cancer

Michael Chung⁴  Silvia Franceschi³  Daniëlle A M Heideman¹  Martyn Plummer³  Samah R Sakr⁵  Nelly R Mugo²  Hugo De Vuyst³  Salvatore Vaccarella³ 

[1] Department of Pathology, VU University Medical Center (VUMC), Amsterdam, The Netherlands;Department of Obstetrics and Gynecology, Kenyatta National Hospital, P.O. Box 19676, off Ngong Road, Nairobi, Kenya;International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon cedex 08 69372, France;Department of Epidemiology, University of Washington, 325 Ninth Avenue, Box 359909, Seattle, WA 98104, USA;Coptic Hospital, P.O. Box 21570, Ngong Road, Nairobi, Kenya

关键词: Multiple infections;    Women;    Prevalence;    HIV;    Human papillomavirus;   

Others  :  801245
DOI  :  10.1186/1750-9378-8-50

 received in 2013-08-31, accepted in 2013-11-18,  发布年份 2013

【 摘 要 】

Background

HIV-positive women are at increased risk of human papillomavirus (HPV) infection, and, especially, multiple infections compared to HIV-negative women. Whether certain HPV types have a tendency to cluster in multiple infections beyond or below what would be expected by shared risk factors (e.g., sexual behavior and the degree of immunosuppression) is unclear. We, therefore, investigated clustering patterns of 44 HPV types in HIV-positive women from Kenya.

Findings

HPV status was assessed on cervical scrapings from 498 women using GP5+/6+ PCR and reverse line blot. Logistic regression was used to model type-specific HPV positivity, adjusted for age, specific HPV type prevalence, CD4, combination antiretroviral therapy, and, in the Full Model, individual-level random effects that represent unobservable risk factors common to all HPV types. We found a modest excess of women with co-infections with 2 HPV types (1.12; 95% credible intervals: 1.03-1.21) in the Full Model but no significant associations of individual types. No significant deviations of observed/expected counts were observed for any 2-way combination of HPV types at either the chosen level of significance, p = 0.00005, or at p = 0.01. Findings were substantially similar when women with CIN2/3 were excluded and when they were stratified by use of anti-retroviral therapy or CD4 count.

Conclusions

HPV co-infections occurred at random in the cervix of HIV-positive women as previously found in HIV-negative women. The removal of HPV types through vaccination should not result, therefore, in an increase or decrease in the prevalence of HPV types not targeted by vaccination in immunosuppressed women.

【 授权许可】

   
2013 Vaccarella et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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