International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000, Ghent, Belgium.
Burnet Institute, Melbourne, VIC, Australia.
Virol J. 2018 Mar 27;15(1):54. doi: 10.1186/s12985-018-0961-3.
Women living with HIV are at increased risk to be co-infected with HPV, persistent high-risk (HR) human papillomavirus (HPV) infection and increased HR HPV viral load, which make them more at risk for cervical cancer. Despite their inherent vulnerability, there is a scarcity of data on potential high risk (pHR) and HR HPV genotypes in HIV- infected women with cervical dysplasia and HPV-type specific viral load in this population in Sub Saharan Africa. The aim of this analysis of HIV-infected women was to explore the virological correlates of high-grade cervical dysplasia (CIN 2+) in HIV-infected women, thereby profiling HPV genotypes.
This analysis assesses baseline data obtained from a cohort study of 74 HIV-infected women with abnormal cytology attending a Comprehensive Care Centre for patients with HIV infection in Mombasa, Kenya. Quantitative real-time PCR was used for HPV typing and viral load.
CIN 2 was observed in 16% (12/74) of women, CIN 3 in 23% (17/74), and, invasive cervical carcinoma (ICC) in 1% (1/74) of women. In women with CIN 3+, HPV 16 (44%), HPV 56 (33%), HPV 33 and 53 (HPV 53 (28%) were the most prevalent genotypes. HPV 53 was observed as a stand-alone HPV in one woman with ICC. A multivariate logistic regression adjusting for age, CD4 count and HPV co-infections suggested the presence of HPV 31 as a predictor of CIN 2+ (adjusted odds ratio [aOR]:4.9; p = 0.05; 95% (Confidence Interval) [CI]:1.03-22.5). Women with CIN2+ had a significantly higher viral log mean of HPV 16, (11.2 copies/ 10,000 cells; 95% CI: 9.0-13.4) than with CIN 1.
The high prevalence of HPV 53 in CIN 3 and as a stand-alone genotype in the patient with invasive cervical cancer warrants that its clinical significance be further revisited among HIV-infected women. HPV 31, along with elevated means of HPV 16 viral load were predictors of CIN 2 + .
HIV 感染者感染 HPV、持续性高危（HR）人乳头瘤病毒（HPV）感染和 HR HPV 病毒载量增加的风险增加，这使她们更容易患宫颈癌。尽管 HIV 感染者存在固有脆弱性，但在撒哈拉以南非洲地区，关于 HIV 感染者中宫颈发育不良和 HPV 型特异性病毒载量的潜在高危（pHR）和 HR HPV 基因型的数据仍然匮乏。本分析旨在探讨 HIV 感染者中高级别宫颈发育不良（CIN 2+）的病毒学相关性，从而对 HPV 基因型进行分析。
本分析评估了来自肯尼亚蒙巴萨 HIV 感染综合护理中心的 74 名异常细胞学 HIV 感染者队列研究的基线数据。采用实时定量 PCR 进行 HPV 分型和病毒载量检测。
16%（12/74）的女性出现 CIN 2，23%（17/74）出现 CIN 3，1%（1/74）出现浸润性宫颈癌（ICC）。在 CIN 3+的女性中，HPV 16（44%）、HPV 56（33%）、HPV 33 和 53（HPV 53（28%）是最常见的基因型。HPV 53 是在一名 ICC 患者中作为单一 HPV 病毒株存在。多变量逻辑回归调整年龄、CD4 计数和 HPV 合并感染后，HPV 31 的存在是 CIN 2+的预测因素（调整后的优势比[OR]：4.9；p=0.05；95%置信区间[CI]：1.03-22.5）。CIN2+的女性 HPV 16 的病毒 log 均值明显更高（11.2 拷贝/10,000 个细胞；95%CI：9.0-13.4），而 CIN1 的女性则更高。
CIN 3 中 HPV 53 的高流行率及其在浸润性宫颈癌患者中的单一基因型存在，需要进一步重新评估其在 HIV 感染者中的临床意义。HPV 31 以及 HPV 16 病毒载量的升高是 CIN 2+的预测因素。
