印度钦奈感染艾滋病毒女性多个解剖部位人乳头瘤病毒感染的患病率及一致性
Prevalence and concordance of human papillomavirus infection at multiple anatomic sites among HIV-infected women from Chennai, India.
作者信息
Menezes Lynette J, Poongulali Selvamuthu, Tommasino Massimo, Lin Hui-Yi, Kumarasamy Nagalingeswaran, Fisher Kate J, Saravanan Shanmugam, Gheit Tarik, Ezhilarasi Chandrasekaran, Jeeva Arumugham, Lu Beibei, Giuliano Anna R
机构信息
Division of Infectious Disease, University of South Florida, Tampa, FL, USA
YRGCARE Medical Centre, VHS, Chennai, India.
出版信息
Int J STD AIDS. 2016 Jun;27(7):543-53. doi: 10.1177/0956462415587226. Epub 2015 May 22.
Human papillomavirus (HPV) infection at the cervix, anus and oropharynx has been rarely concurrently estimated among HIV-infected women. Using multiplex polymerase chain reaction testing, we prospectively evaluated HPV genotype distribution across three anatomic sites among 50 eligible HIV-infected women from Chennai, India, who provided biological specimens and answered a sexual behaviour questionnaire. We also assessed clinical and behavioural factors related to HPV prevalence. Oncogenic HPV prevalence was comparable between the anus and cervix at 52.2% and 52.0% and lower at the oropharynx at 13.2%; 78% of women with a cervical HPV infection had the same type in the anus. Newly acquired oncogenic HPV infections were lower at cervix (24%) than anus (35%) at three months. 'Any type' cervical HPV prevalence was higher among women with low education and less than five years since HIV diagnosis. CD4+ count and antiretroviral therapy status were not associated with HPV prevalence at the three anatomic sites; however, enrolment cervical HPV16 prevalence was elevated among women with nadir CD4+ <200 cells/µL and enrolment CD4+ <350 cells/µL. Regular cervical screening is essential in HIV-infected Indian women irrespective of CD4+ count and antiretroviral therapy status. Additional research clarifying the natural history of anal HPV infection is also needed in this population.
在感染艾滋病毒的女性中,很少同时对子宫颈、肛门和口咽的人乳头瘤病毒(HPV)感染情况进行评估。我们采用多重聚合酶链反应检测,对来自印度金奈的50名符合条件的感染艾滋病毒的女性进行了前瞻性评估,这些女性提供了生物样本并回答了性行为调查问卷,以了解三个解剖部位的HPV基因型分布情况。我们还评估了与HPV流行率相关的临床和行为因素。肛门和子宫颈的致癌性HPV流行率相当,分别为52.2%和52.0%,口咽部位的流行率较低,为13.2%;78%子宫颈感染HPV的女性在肛门部位感染的是同一类型。三个月时,子宫颈新获得的致癌性HPV感染率(24%)低于肛门(35%)。教育程度低且自艾滋病毒诊断以来不到五年的女性中,“任何类型”的子宫颈HPV流行率较高。CD4+细胞计数和抗逆转录病毒治疗状态与三个解剖部位的HPV流行率无关;然而,最低点CD4+<200个细胞/微升且入组时CD4+<350个细胞/微升的女性中,入组时子宫颈HPV16流行率升高。对于感染艾滋病毒的印度女性,无论CD4+细胞计数和抗逆转录病毒治疗状态如何,定期进行子宫颈筛查至关重要。该人群还需要开展更多研究以阐明肛门HPV感染的自然史。