Yamada Rika, Sasagawa Toshiyuki, Kirumbi Leah W, Kingoro Alan, Karanja Dominic K, Kiptoo Michael, Nakitare George W, Ichimura Hiroshi, Inoue Masaki
Molecular Reproductive Biology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa, Japan.
J Med Virol. 2008 May;80(5):847-55. doi: 10.1002/jmv.21170.
Human papillomavirus (HPV) infection and cervical abnormalities, and their association with human immunodeficiency virus (HIV) infection were studied in 488 women who visited a health center in Nairobi. PCR-based HPV and cervical cytology tests were carried out on all participants, and peripheral CD4+ T cells and plasma HIV RNA were quantitated in HIV positive women. HIV were positive in 32% (155/488) of the women; 77% of these were untreated, and the others had been treated with anti-retroviral drugs within 6 months. Cervical HPV infection was detected in 17% of HIV negative and 49% of HIV positive women. Low-grade squamous intraepithelial lesions were observed in 6.9% of HIV negative and 21% of HIV positive women, while high-grade squamous intraepithelial lesions and cancer were seen in 0.6% and 5.8%, respectively. Multivariate analysis revealed that HIV and HPV infections were associated with each other. Cervical lesions were significantly associated with high-risk HPVs and with HIV infection, depending on HPV infection. HPV infection increased in accordance with lower CD4+ T cell counts and higher HIV RNA levels, and high-grade lesions were strongly associated with high-risk HPV infection and low CD4+ T cell counts. Immunosuppression as a result of HIV infection appears to be important for malignant progression in the cervix. Nationwide prevention of HIV infection and cervical cancer screening are necessary for the health of women in this area. High-risk HPV infection and low CD4+ T cell counts are the risk factors for cervical cancer.
对在内罗毕一家健康中心就诊的488名女性进行了人乳头瘤病毒（HPV）感染与宫颈异常情况及其与人类免疫缺陷病毒（HIV）感染之间关联的研究。对所有参与者进行了基于聚合酶链反应（PCR）的HPV检测和宫颈细胞学检查，并对HIV阳性女性的外周血CD4 + T细胞和血浆HIV RNA进行了定量分析。32%（155/488）的女性HIV呈阳性；其中77%未接受治疗，其余在6个月内接受了抗逆转录病毒药物治疗。在HIV阴性女性中，17%检测出宫颈HPV感染，而在HIV阳性女性中这一比例为49%。在HIV阴性女性中，6.9%观察到低度鳞状上皮内病变，在HIV阳性女性中这一比例为21%，而高度鳞状上皮内病变和癌症的比例分别为0.6%和5.8%。多变量分析显示，HIV感染与HPV感染相互关联。宫颈病变与高危HPV以及HIV感染显著相关，具体取决于HPV感染情况。HPV感染随着CD4 + T细胞计数降低和HIV RNA水平升高而增加，高度病变与高危HPV感染和低CD4 + T细胞计数密切相关。HIV感染导致的免疫抑制似乎对宫颈恶性进展至关重要。为了该地区女性的健康，有必要在全国范围内预防HIV感染并开展宫颈癌筛查。高危HPV感染和低CD4 + T细胞计数是宫颈癌的危险因素。
