Dols Joke A M, Reid Gregor, Brown Joelle M, Tempelman Hugo, Bontekoe Tj Romke, Quint Wim G V, Boon Mathilde E
Erasmus MC, University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
ISRN Obstet Gynecol. 2012;2012:514146. doi: 10.5402/2012/514146. Epub 2012 Jun 28.
Background. There are limited data on high-risk human papillomavirus (hr-HPV) genotypes among HIV-positive women in Africa, and little is known about their relationship with cervical cytology in these populations. Methods. We conducted a cross-sectional study among 194 HIV-positive women (143 from Tanzania, and 51 from South Africa) to evaluate HPV genotypes among HIV-positive women with normal and abnormal cytology. Cervical samples were genotyped for HPV types, and slides were evaluated for atypical squamous cell changes according to the Bethesda classification system. Results. Prevalence of high grade squamous intraepithelial dysplasia (HSIL) was 9%. Overall, more than half (56%) of women were infected with an hr-HPV type; 94% of women with HSIL (n = 16), 90% of women with LSIL (n = 35), and 42% of women within normal limits (WNL) (n = 58) tested positive for hr-HPV. Overall, the most prevalent hr-HPV subtypes were HPV16 (26%) and HPV52 (30%). Regional differences in the prevalence of HPV18 and HPV35 were found. Conclusion. Regional differences in HPV genotypes among African women warrant the need to consider different monitoring programmes for cervical preneoplasia. HPV-based screening tests for cervical preneoplasia would be highly inefficient unless coupled with cytology screening of the HPV-positive sample, especially in HIV-positive women.
背景。关于非洲艾滋病毒阳性女性中高危型人乳头瘤病毒（hr-HPV）基因型的数据有限，且对这些人群中其与宫颈细胞学的关系知之甚少。方法。我们对194名艾滋病毒阳性女性（143名来自坦桑尼亚，51名来自南非）进行了一项横断面研究，以评估细胞学正常和异常的艾滋病毒阳性女性中的HPV基因型。对宫颈样本进行HPV分型基因检测，并根据贝塞斯达分类系统对玻片进行非典型鳞状细胞变化评估。结果。高级别鳞状上皮内瘤变（HSIL）的患病率为9%。总体而言，超过一半（56%）的女性感染了hr-HPV型；HSIL女性（n = 16）中有94%、低级别鳞状上皮内瘤变（LSIL）女性（n = 35）中有90%以及细胞学正常（WNL）女性（n = 58）中有42%的hr-HPV检测呈阳性。总体而言，最常见的hr-HPV亚型是HPV16（26%）和HPV52（30%）。发现了HPV18和HPV35患病率的区域差异。结论。非洲女性中HPV基因型的区域差异表明有必要考虑针对宫颈瘤变前期制定不同的监测方案。基于HPV的宫颈瘤变前期筛查测试效率会非常低，除非与HPV阳性样本的细胞学筛查相结合，尤其是在艾滋病毒阳性女性中。
