Department of Pediatrics, Meharry Medical College.
Meharry Medical College.
J Natl Med Assoc. 2016 Feb;108(1):19-23. doi: 10.1016/j.jnma.2015.12.003.
Persistent high risk human papillomavirus (hrHPV) has been associated with cervical abnormalities and cancer. There are few studies comparing HIV-infected with uninfected African American women from the Southern U.S. We evaluated medical records of a women's cohort in an urban clinic in Tennessee to assess the prevalence of hrHPV and cytology correlates, as well as HPV vaccination rates.
We reviewed medical records of 50 HIV infected and 304 HIV uninfected women, including Pap smears and hrHPV.
HIV-infected women were older than HIV-uninfected women (p<0.0001) and were more likely to have hrHPV (p=<0.0001) and LGSIL/HGSIL (p=0.006). Within the HIV uninfected group, Hispanic women were younger than non-Hispanic African American women (p=0.04) and non-Hispanic white women (p=0.0002). Non-Hispanic African-American women were younger (p=0.004) than non-Hispanic white women. Both HIV-uninfected and HIV-infected women had an 11-fold and 5-fold odds, respectively, of having precancerous lesions when harboring hrHPV, compared to hrHPV-uninfected women. Of the 125 HIV-uninfected women, only 17% had received at least one dose of the HPV vaccine. None of the 21 vaccine recipients had evidence of SILs compared to 9% of vaccine non-recipients (p=0.35, Fisher's exact test).
HIV-infected women remained at significantly higher risk for developing cervical precancerous lesions when exposed to hrHPV than their uninfected counterparts. Hispanic women were least likely to have been vaccinated. Missed HPV vaccination trended towards being associated with a higher odds of precancerous lesions. Routine HPV vaccination should be reinforced for adolescents and young women using public hospital facilities of all races and ethnic backgrounds.
持续性高危型人乳头瘤病毒（hrHPV）与宫颈异常和癌症有关。目前，关于美国南部感染艾滋病毒的非裔美国女性与未感染艾滋病毒的非裔美国女性的比较研究较少。我们评估了田纳西州一家城市诊所女性队列的医疗记录，以评估 hrHPV 和细胞学相关性的流行率，以及 HPV 疫苗接种率。
我们回顾了 50 名 HIV 感染和 304 名 HIV 未感染女性的医疗记录，包括巴氏涂片和 hrHPV。
HIV 感染女性比 HIV 未感染女性年龄更大（p<0.0001），且更有可能感染 hrHPV（p<0.0001）和 LGSIL/HGSIL（p=0.006）。在 HIV 未感染组中，西班牙裔女性比非西班牙裔非裔美国女性（p=0.04）和非西班牙裔白人女性（p=0.0002）年轻。非西班牙裔非裔美国女性比非西班牙裔白人女性年轻（p=0.004）。与未感染 hrHPV 的女性相比，无论是 HIV 未感染还是 HIV 感染的女性，当感染 hrHPV 时，发生癌前病变的几率分别为 11 倍和 5 倍。在 125 名 HIV 未感染女性中，只有 17%至少接种了一剂 HPV 疫苗。与未接种疫苗的女性相比，21 名疫苗接种者中没有证据表明存在 SILs（p=0.35，Fisher 确切检验）。
与未感染的对照组相比，暴露于 hrHPV 的 HIV 感染女性发展宫颈癌前病变的风险显著更高。西班牙裔女性接种疫苗的可能性最小。错过 HPV 疫苗接种的趋势与癌前病变的更高几率相关。应加强针对所有种族和族裔背景的青少年和年轻女性的常规 HPV 疫苗接种。
