Cambou Mary C, Levi José Eduardo, Lake Jordan E, de Andrade Angela, Jalil Emilia M, Russomano Fabio, Derrico Mônica, Veloso Valdilea G, Friedman Ruth K, Luz Paula M, Grinsztejn Beatriz
Department of Medicine, Division of Infectious Diseases, Program in Global Health, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA 90095, USA; Department of Internal Medicine, Montefiore University Hospital of Albert Einstein College of Medicine, Bronx, New York, USA.
Virology Laboratory, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil.
Int J Infect Dis. 2015 Dec;41:17-20. doi: 10.1016/j.ijid.2015.10.017. Epub 2015 Oct 28.
HIV-infected women are at increased risk of human papillomavirus (HPV) infection. Time trends in annual prevalences of cervical high-risk human papillomavirus (HR-HPV) genotypes among a non-vaccinated, HIV-infected female cohort in urban Brazil were assessed for the period 2006-2012.
Cervical specimens were collected for HPV genotyping yearly between January 2006 and December 2012 in a cross-sectional analysis of participants aged ≥18 years enrolled in the Women's HIV Cohort at Fiocruz in Rio de Janeiro, Brazil. Age-adjusted generalized estimating equation models with an exchangeable matrix were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for annual HPV positivity (reference year: 2006).
Among the 590 participants, the median age across all study years ranged from 35.5 to 40.0 years. The prevalence of any HR-HPV was ≥53% every year; prevalences of HR-HPV 16, 58, 59, and 68 were ≥24% in at least 1 year. The odds of HPV 16 and 68 decreased in 2012. HPV 58 prevalence followed a U-shape, beginning and ending at >20%. HPV 59 prevalence followed a linear trend, with increased odds in 2012 (OR 16.0, 95% CI 3.8-67.3; Bonferroni-adjusted p-value <0.01).
The prevalences of HR-HPV 58, 59, and 68 were high in this cohort. Given current HR-HPV vaccine coverage and availability, further investigations are needed to optimize vaccine recommendations for this population.
感染艾滋病毒的女性感染人乳头瘤病毒（HPV）的风险更高。对2006年至2012年期间巴西城市中未接种疫苗、感染艾滋病毒的女性队列中宫颈高危人乳头瘤病毒（HR-HPV）基因型的年度患病率的时间趋势进行了评估。
在巴西里约热内卢的菲奥克鲁兹妇女艾滋病毒队列中，对年龄≥18岁的参与者进行横断面分析，于2006年1月至2012年12月期间每年收集宫颈标本进行HPV基因分型。使用具有可交换矩阵的年龄调整广义估计方程模型来估计年度HPV阳性的比值比（OR）和95%置信区间（CI）（参考年份：2006年）。
在590名参与者中，所有研究年份的中位年龄在35.5至40.0岁之间。每年任何HR-HPV的患病率均≥53%；HR-HPV 16、58、59和68的患病率在至少1年中≥24%。2012年HPV 16和68的感染几率下降。HPV 58的患病率呈U形，开始和结束时均>20%。HPV 59的患病率呈线性趋势，2012年感染几率增加（OR 16.0，95%CI 3.8-67.3；经邦费罗尼校正的p值<0.01）。
该队列中HR-HPV 58、59和68的患病率较高。鉴于目前HR-HPV疫苗的覆盖率和可及性，需要进一步调查以优化针对该人群的疫苗建议。
