高危型人乳头瘤病毒在宫颈细胞学正常的 HIV 感染妇女中的研究：尼日利亚乔斯的一项初步研究。

High-risk human papillomavirus among HIV-infected women with normal cervical cytology: a pilot study in Jos, Nigeria.

机构信息

Department of Obstetrics and Gynecology, University of Jos, Jos, Nigeria,

出版信息

Arch Gynecol Obstet. 2013 Dec;288(6):1365-70. doi: 10.1007/s00404-013-2885-x. Epub 2013 May 23.

DOI:10.1007/s00404-013-2885-x

PMID:23700253

Abstract

BACKGROUND

Cervical cancer is strongly linked to high-risk human papillomavirus (HR-HPV) and is typically preceded by cytological abnormalities. Less is known in patients with normal cervical cytology (NCC). We investigated the epidemiology of HR-HPV among HIV-infected women with NCC.

METHODOLOGY

We conducted a cross-sectional study between January and June 2011 among HIV-infected women with NCC at an adult HIV clinic in Jos, Nigeria. Cervical sampling and analysis for HR-HPV by hybrid capture (HC2) with signal amplification was done to determine presence of one or more of the following HR-HPV types: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 or 68. Epidemiologic factors associated with HR-HPV were determined using bivariate statistics and multivariate logistic regression.

RESULTS

We evaluated 103 HIV-infected women with Pap cytology. The median age of the women was 32 years (range 21-49). Ninety-seven (94.2%) had NCC. Cervical samples for HR-HPV DNA testing were available from 89/97 (91.8%) of the HIV-infected women with NCC. Of the 89 women with cervical samples for HR-HPV DNA testing, 40 (44.9%) had detectable HR-HPV by HC2 giving a HR-HPV prevalence of 44.9% (95% CI 33.9-55.5%). Age < 30 years was associated with HR-HPV (OR 2.69 [95% CI 1.05-6.91, p = 0.039]) while history of previous abortion showed an inverse association with HR-HPV (OR 0.33[95% CI 0.15-0.94, p = 0.039]).

CONCLUSION

The prevalence of HR-HPV is seemingly high among HIV-infected women with NCC in our clinical setting. These data provide support for further investigation of the clinical implications of positive HR-HPV among HIV-infected women with NCC report in cervical cancer prevention programs in Nigeria.

摘要

背景

宫颈癌与高危型人乳头瘤病毒（HR-HPV）密切相关，通常在细胞学异常之前出现。在宫颈细胞学正常（NCC）的患者中，了解较少。我们研究了 HIV 感染的 NCC 患者中 HR-HPV 的流行病学。

方法

我们在 2011 年 1 月至 6 月期间在尼日利亚乔斯的一家成人 HIV 诊所进行了一项横断面研究，纳入了 HR-HPV 感染的 NCC 患者。通过杂交捕获（HC2）信号放大技术进行宫颈取样和 HR-HPV 分析，以确定存在一种或多种以下 HR-HPV 类型：16、18、31、33、35、39、45、51、52、56、58、59 或 68。使用双变量统计和多变量逻辑回归确定与 HR-HPV 相关的流行病学因素。

结果

我们评估了 103 名 HIV 感染的 Pap 细胞学患者。女性的中位年龄为 32 岁（范围 21-49 岁）。97 名（94.2%）有 NCC。89 名 HR-HPV 感染的 NCC 患者中有 89 名（91.8%）可进行宫颈样本 HR-HPV DNA 检测。在 89 名进行 HR-HPV DNA 检测的宫颈样本中，40 名（44.9%）通过 HC2 检测到 HR-HPV，HR-HPV 检出率为 44.9%（95%CI 33.9-55.5%）。年龄<30 岁与 HR-HPV 相关（OR 2.69 [95%CI 1.05-6.91，p = 0.039]），而既往流产史与 HR-HPV 呈负相关（OR 0.33[95%CI 0.15-0.94，p = 0.039]）。