Roccio M, Dal Bello B, Gardella B, Carrara M, Gulminetti R, Mariani B, Spinillo A
Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo Pavia, Italy.
Curr HIV Res. 2012 Oct;10(7):614-9. doi: 10.2174/157016212803305998.
Human Papillomavirus infections have been shown to be crucial for the development of cervical intraepithelial neoplasia and subsequent cervical cancer. The aim of this study is to describe the prevalence of different genotypes of HPV, in a population of HIV-positive women, compared to the negative ones, and their oncogenic risk.
A case-control study comparing HPV genotype distribution between 93 HIV-seropositive and 186 HIV-seronegative women, matched for age and severity of cervical lesions, who attending colposcopic service of our departments for periodical Pap smear and HPV DNA full genotyping by SPF-10 LiPA assay.
No significant difference was found in genotype distribution between HIV positive and HIV negative women. Only the prevalence of HPV56 was higher in HIV positive women (p=0,046). The rates of HPV 6, 11, 16 and 18 were similar in both groups. The likelihood of the detection of three or more HPV genotypes was significantly associated with CIN (OR=2.0; 95% CI=1.1-3.8; p= 0.026) but only marginally to HIV-positive serostatus (OR=1.68; 95% CI=0.89-3.16; p= 0.1). High grade cervical lesions are associated with high risk viruses like HPV 16 and 18 and with multiple cervical HPV infections.
The tendency to treat HIV disease with high active antiretroviral therapy may reduce the impact of immunosuppression and make the course of such HPV infections more similar to that among women who are not HIVinfected. As in immunocompetent women, high oncogenic risk viral type and multiple infections are associated with a histologically proven cervical intraepithelial lesions.
人乳头瘤病毒感染已被证明对宫颈上皮内瘤变及后续宫颈癌的发生至关重要。本研究旨在描述与HIV阴性女性相比，HIV阳性女性群体中不同基因型HPV的流行情况及其致癌风险。
一项病例对照研究，比较了93名HIV血清阳性和186名HIV血清阴性女性的HPV基因型分布，这些女性年龄和宫颈病变严重程度相匹配，她们因定期巴氏涂片检查和通过SPF-10线性探针分析进行HPV DNA全基因分型而前来我们科室接受阴道镜检查。
HIV阳性和HIV阴性女性的基因型分布未发现显著差异。仅HIV阳性女性中HPV56的流行率较高（p = 0.046）。两组中HPV 6、11、16和18的感染率相似。检测到三种或更多HPV基因型的可能性与CIN显著相关（OR = 2.0；95% CI = 1.1 - 3.8；p = 0.026），但与HIV阳性血清状态仅呈微弱相关（OR = 1.68；95% CI = 0.89 - 3.16；p = 0.1）。高级别宫颈病变与HPV 16和18等高风险病毒以及多种宫颈HPV感染相关。
采用高效抗逆转录病毒疗法治疗HIV疾病的趋势可能会降低免疫抑制的影响，使此类HPV感染的病程更类似于未感染HIV的女性。与免疫功能正常的女性一样，高致癌风险病毒类型和多重感染与组织学证实的宫颈上皮内病变相关。
