Thunga Suchitra, Andrews Anusmitha, Ramapuram John, Satyamoorthy Kapaettu, Kini Hema, Unnikrishnan B, Adhikari Prabha, Singh Prakhar, Kabekkodu Shama Prasada, Bhat Samatha, Kadam Anagha, Shetty Avinash K
Department of OBG, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
Life Line Hospital, Pathanamthitta, Kerala, India.
J Obstet Gynaecol Res. 2016 Dec;42(12):1822-1828. doi: 10.1111/jog.13111. Epub 2016 Sep 19.
The aim of this study was to examine the association between CD4 count, human papilloma virus (HPV) infection, and the risk of cervical intraepithelial neoplasia among HIV-infected women.
A cross-sectional study was conducted among 104 HIV-infected women attending an antiretroviral therapy clinic. They underwent Pap smear and cervical HPV DNA testing.
The overall prevalence of HPV infection was 57.7%. HPV 16 was the commonest genotype found (38.5%); HPV 16 and 18 put together contributed to 73.3% of HPV infection; 27.5% of HIV-infected women had squamous cell abnormalities. Cervical intraepithelial neoplasia was less likely among women with CD4 count > 500/mm (12%) and in those without opportunistic infections (17.8%). The prevalence of high-risk HPV infection was higher in women with high-grade squamous intraepithelial lesions or greater lesions (85.7%) as compared to women with normal cytology (52.1%).
The high prevalence of HPV infection and cervical intraepithelial neoplasia in HIV-infected women warrants the need for regular Pap smear screening in these women and routine HPV vaccination for adolescents to reduce the burden of cervical cancer in India.
本研究旨在探讨人类免疫缺陷病毒（HIV）感染女性的CD4细胞计数、人乳头瘤病毒（HPV）感染与宫颈上皮内瘤变风险之间的关联。
对在一家抗逆转录病毒治疗诊所就诊的104名HIV感染女性进行了一项横断面研究。她们接受了巴氏涂片检查和宫颈HPV DNA检测。
HPV感染的总体患病率为57.7%。发现最常见的基因型是HPV 16（38.5%）；HPV 16和18共同构成了73.3%的HPV感染；27.5%的HIV感染女性有鳞状细胞异常。CD4细胞计数>500/mm³的女性（12%）和无机会性感染的女性（17.8%）发生宫颈上皮内瘤变的可能性较小。与细胞学正常的女性（52.1%）相比，高级别鳞状上皮内病变或更严重病变的女性中高危HPV感染的患病率更高（85.7%）。
HIV感染女性中HPV感染和宫颈上皮内瘤变的高患病率表明，有必要对这些女性进行定期巴氏涂片筛查，并对青少年进行常规HPV疫苗接种，以减轻印度宫颈癌的负担。
