Mujuni Fridolin, Mirambo Mariam M, Rambau Peter, Klaus Korn, Andreas Muller, Matovelo Dismas, Majigo Mtebe, Kasang Christa, Mshana Stephen E
Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
Infect Agent Cancer. 2016 Aug 19;11:49. doi: 10.1186/s13027-016-0097-2. eCollection 2016.
High risk (HR) human papilloma Virus (HPV) genotypes have been associated with cervical cancer. In Tanzania there is a limited data on the epidemiology of HPV and genotypes distribution among HIV infected women. Here we document varieties of HPV genotypes associated with cervical squamous intraepithelial lesions (SIL) among HIV- infected women at Bugando Medical Centre, Mwanza-Tanzania.
A cross sectional hospital based study involving HIV infected women was conducted between August and October, 2014. Exfoliated cells from ectocervix and endocervix were collected using cytobrush. HPV genotypes were detected using polymerase chain reaction (PCR) followed by sequencing using specific primers targeting broad range of HPV types. Cytology was done to establish squamous intraepithelial lesions. Log binomial regression analysis was done to establish risk ratios (RR) associated with HPV infection using STATA version 11.
A total of 255 HIV infected women with mean age 39.2 ± 9.1 years were enrolled in the study. HPV DNA was detected in 138/255 (54.1 %, 95 % CI: 47-60) of HIV infected women. Twenty six genotypes were detected in various combinations; of these 17(65.3 %) were of HR genotypes. HR genotypes were detected in 124(48.6 %) of HIV infected women. Common HR genotypes detected were HPV-52(26), HPV-58(21), HPV-35(20) and HPV-16(14). The risk of being HPV positive was significantly higher among women with CD4 counts <100 (RR: 1.20, 95 % CI: 1.05-1.35, P = 0.006) and women with SIL (RR: 1.37, 95 % CI: 1.11-1.68, P = 0.005).
Significant proportion of HIV infected women with low CD4 counts have various grades of cervical SIL associated with varieties of uncommon HR genotypes. There is a need to evaluate the effectiveness of the current vaccine in preventing cervical cancer in developing countries where HIV is endemic.
高危（HR）型人乳头瘤病毒（HPV）基因型与宫颈癌相关。在坦桑尼亚，关于HPV流行病学及HIV感染女性中基因型分布的数据有限。在此，我们记录了坦桑尼亚姆万扎布甘多医疗中心HIV感染女性中与宫颈鳞状上皮内病变（SIL）相关的多种HPV基因型。
2014年8月至10月开展了一项基于医院的横断面研究，纳入HIV感染女性。使用细胞刷收集宫颈外口和宫颈内口的脱落细胞。采用聚合酶链反应（PCR）检测HPV基因型，随后使用针对多种HPV类型的特异性引物进行测序。进行细胞学检查以确定鳞状上皮内病变。使用STATA 11版进行对数二项回归分析，以确定与HPV感染相关的风险比（RR）。
共纳入255名平均年龄为39.2±9.1岁的HIV感染女性。138/255（54.1%，95%CI：47 - 60）的HIV感染女性检测到HPV DNA。检测到26种基因型的不同组合；其中17种（65.3%）为HR基因型。124（48.6%）名HIV感染女性检测到HR基因型。检测到的常见HR基因型为HPV - 52（26例）、HPV - 58（21例）、HPV - 35（20例）和HPV - 16（14例）。CD4计数<100的女性HPV阳性风险显著更高（RR：1.20，95%CI：1.05 - 1.35，P = 0.006），有SIL的女性也是如此（RR：1.37，95%CI：1.11 - 1.68，P = 0.005）。
相当比例CD4计数低的HIV感染女性有不同级别的宫颈SIL，与多种不常见的HR基因型相关。在HIV流行的发展中国家，有必要评估当前疫苗预防宫颈癌的有效性。
