在接受抗逆转录病毒治疗的女性中，HIV-1 生殖器脱落与宫颈上皮内瘤变 2/3 之间是否存在关联？

Is there an association between HIV-1 genital shedding and cervical intraepithelial neoplasia 2/3 among women on antiretroviral therapy?

机构信息

Department of Obstetrics, Gynecology and Reproductive Services, University of California, San Francisco, San Franciso, CA 94105, USA.

出版信息

J Low Genit Tract Dis. 2013 Jul;17(3):354-60. doi: 10.1097/LGT.0b013e3182712286.

DOI:10.1097/LGT.0b013e3182712286

PMID:23486070

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3690152/

Abstract

OBJECTIVE

Given the high prevalence of cervical intraepithelial neoplasia (CIN) grade 2/3 among HIV-infected women, we sought to examine the relationship between CIN 2/3 and HIV-1 genital shedding among women on highly active antiretroviral therapy (HAART).

MATERIALS AND METHODS

Paired plasma and cervical wick specimens for HIV-1 RNA measurements were obtained from 44 HIV-infected women with biopsy-confirmed CIN 2/3 (cases) and 44 age-matched HIV-infected women with normal cervical findings on colposcopy (controls). All subjects tested negative for sexually transmitted infections and had been stable on HAART for at least 3 months. HIV-1 viral load was measured in both blood and cervical specimens using commercial real-time polymerase chain reaction assays.

RESULTS

Cervical intraepithelial neoplasia 2/3 was not significantly associated with the detection or magnitude of plasma or cervical HIV-1 RNA shedding. HIV was detected in the plasma in 10 cases (23%) and 10 controls (25%) (odds ratio = 1.0; 95% confidence interval = 0.33-3.1). Cervical HIV-1 was detected in 6 cases (13.6%) and 9 controls (20.4%) (odds ratio = 0.61; 95% confidence interval = 0.20-1.90). Mean HIV-1 concentration in cervical secretions among women with CIN 2/3 who shed was 2.93 log10 copies versus 2.72 among controls (p = .65).

CONCLUSIONS

Among women on HAART, we found no relationship between CIN 2/3 and HIV-1 genital shedding.

摘要

目的

鉴于感染 HIV 的女性中宫颈上皮内瘤变（CIN）2/3 级的高患病率，我们试图研究在接受高效抗逆转录病毒治疗（HAART）的女性中，CIN 2/3 与 HIV-1 生殖器脱落之间的关系。

材料和方法

从 44 名经活检证实患有 CIN 2/3（病例）的 HIV 感染女性和 44 名年龄匹配的经阴道镜检查发现宫颈正常的 HIV 感染女性中获得了配对的血浆和宫颈拭子标本，用于 HIV-1 RNA 测量。所有受试者均经性传播感染检测呈阴性，且已接受 HAART 治疗至少 3 个月。使用商业实时聚合酶链反应检测试剂盒分别测量血液和宫颈标本中的 HIV-1 病毒载量。

结果

CIN 2/3 与血浆或宫颈 HIV-1 RNA 脱落的检测或幅度均无显著相关性。10 例（23%）病例和 10 例（25%）对照中（比值比=1.0；95%置信区间=0.33-3.1）在血浆中检测到 HIV。6 例（13.6%）病例和 9 例（20.4%）对照（比值比=0.61；95%置信区间=0.20-1.90）在宫颈中检测到 HIV。CIN 2/3 且有生殖器脱落的女性的宫颈分泌物中 HIV-1 的平均浓度为 2.93 log10 拷贝，而对照组为 2.72（p=0.65）。