Rovelli Cristina, Poli Andrea, Galli Laura, Cernuschi Massimo, Tamburini Andrea Marco, Racca Sara, Tambussi Giuseppe, Rolla Serena, Albarello Luca, Rosati Riccardo, Lazzarin Adriano, Castagna Antonella, Nozza Silvia
Università Vita-Salute San Raffaele, Milan, Italy.
Infectious Diseases Department, San Raffaele Scientific Institute, Milan, Italy.
PLoS One. 2017 Oct 31;12(10):e0186367. doi: 10.1371/journal.pone.0186367. eCollection 2017.
The aim of the study was to determine the prevalence of abnormal cytological findings, high risk (HR)-HPV genotypes and to identify factors associated with an abnormal cytological findings in a cohort of HIV-infected males.
Retrospective observational study on HIV-infected male patients who performed screening in the absence of clinical symptoms. Cytological abnormalities were classified as atypical squamous cells of undetermined significance (ASC-US), low-grade(LSIL) or high high-grade squamous intraepithelial lesion (HSIL). Logistic regression models were used to identify predictors of having LSIL/HSIL.
Among 875 pts, abnormal cytology findings were observed in 254 (29%, 95% CI: 26.1%-32.1%) subjects: 142 (16%) had LSIL and 49 (6%) HSIL. Overall, 581 (66%, 95%CI: 63.2%-69.5%) subjects had ≥1 HR-HPV type and 269 (31%) had ≥2 HR HPV types. Multivariate logistic regression showed that subjects with multiple HR-HPV genotypes (OR = 1.351, 95%CI: 1.005-2.111) and with HPV-16 type (OR = 2.032, 95%CI: 1.313-3.146) were more likely to have LSIL/HSIL in addition to a lower CD4+/CD8+ ratio, a previous diagnosis of syphilis and a positive viral load. In another multivariate model, the presence of multiple HPV types in subjects with HPV-16 type was associated with the highest adjusted OR of having a LSIL/HSIL (OR = 2.598, 95%CI: 1.460-4.624).
In HIV-infected men, the prevalence of abnormal cytological findings was of 29% and of HR-HPV was 66%. The concomitant presence of HPV-16 and multiple HR genotypes was associated with an increased risk of abnormal cytological findings. These data highlight the importance of screening multiple HPV genotypes in HIV-infected patients.
本研究旨在确定异常细胞学检查结果、高危（HR）-HPV基因型的患病率，并确定一组HIV感染男性中与异常细胞学检查结果相关的因素。
对无症状的HIV感染男性患者进行回顾性观察研究。细胞学异常分为意义不明确的非典型鳞状细胞（ASC-US）、低级别（LSIL）或高级别鳞状上皮内病变（HSIL）。采用逻辑回归模型确定LSIL/HSIL的预测因素。
在875例患者中，254例（29%，95%CI：26.1%-32.1%）受试者出现异常细胞学检查结果：142例（16%）有LSIL，49例（6%）有HSIL。总体而言，581例（66%，95%CI：63.2%-69.5%）受试者有≥1种HR-HPV型别，269例（31%）有≥2种HR-HPV型别。多因素逻辑回归显示，除了CD4+/CD8+比值较低、既往梅毒诊断和病毒载量阳性外，具有多种HR-HPV基因型（OR = 1.351，95%CI：1.005-2.111）和HPV-16型（OR = 2.032，95%CI：1.313-3.146）的受试者更有可能出现LSIL/HSIL。在另一个多因素模型中，HPV-16型受试者中多种HPV型别的存在与出现LSIL/HSIL的调整后OR最高相关（OR = 2.598，95%CI：1.460-4.624）。
在HIV感染男性中，异常细胞学检查结果的患病率为29%，HR-HPV的患病率为66%。HPV-16和多种HR基因型同时存在与异常细胞学检查结果风险增加相关。这些数据凸显了在HIV感染患者中筛查多种HPV基因型的重要性。
