A cross-sectional study of high-risk human papillomavirus clustering and cervical outcomes in HIV-infected women in Rio de Janeiro, Brazil

BMC Cancer

Research Article

Tazio Vanni¹  Mary Catherine Cambou²  Jessica L. Castilho³  Angela de Andrade⁴  Ruth K. Friedman⁴  Beatriz Grinsztejn⁴  Paula M. Luz⁴  Mônica Derrico⁴  Valdiléa G. Veloso⁴  José Eduardo Levi⁵ 

[1] Departamento de Ciência e Tecnologia, Ministério da Saúde, Brasília, Brazil;Division of Infectious Diseases and Program in Global Health, David Geffen School of Medicine at UCLA, Los Angeles, USA;Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, USA;Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil;Virology Lab, Instituto de Medicina Tropical da Universidade de São Paulo, São Paulo, Brazil;

关键词: HPV;    Women;    HIV;    Cervical cancer;    Epidemiology;   

DOI  :  10.1186/s12885-015-1486-4

 received in 2015-01-13, accepted in 2015-06-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn Brazil, the rate of cervical cancer remains high despite the availability of screening programs. With ongoing vaccine development and implementation, information on the prevalence of specific HPV types is needed, particularly among high-risk populations, such as HIV-infected women.MethodsWe performed a study of HIV-infected women in Rio de Janeiro, Brazil, who underwent cervical HPV genotype testing between 2005-2013. We examined the prevalence of high-risk HPV types and the patterns of high-risk HPV type clustering. Using logarithmic binomial regression, we estimated the risk of abnormal cytology by HPV genotype result.ResultsOf the 562 women included, 498 (89 %) had at least one HPV type detected. 364 women (65 %) had at least one high-risk HPV type detected and 181 (32 %) had more than one high-risk type detected. HPV 58 was the most frequent HPV type detected overall (prevalence 19.8 % [95 % confidence interval 16.4–23.1]), followed by HPV 53 (prevalence 15.5 % [12.5–18.5]) and HPV 16 (prevalence 13 % [10.2–15.8]). Women infected with more than one high-risk HPV type were younger, had lower CD4+ lymphocyte counts, and were more likely to be infected with HPV 16 or 18. In adjusted analyses, presence of more than one high-risk HPV type was associated with a two-fold increased risk of abnormal cytology after adjusting for presence of individual high-risk type, age, and CD4+ lymphocyte count (adjusted prevalence ratios 1.88–2.07, all p <0.001). No single high-risk HPV type was statistically associated with abnormal cytology after adjusting for the presence of more than one high-risk HPV type.ConclusionsIn the largest study of cervical HPV genotypes among HIV-infected women in Latin America, infection by high-risk HPV types other than 16 or 18 and infection by more than one high-risk HPV types were common. Infection by more than one high-risk type was more strongly associated with abnormal cervical cytology than any individual high-risk HPV type, highlighting the need for multi-valent HPV vaccines.

【 授权许可】

CC BY   
© Castilho et al. 2015