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肯尼亚蒙巴萨感染艾滋病毒的女性中高级别宫颈发育不良与人类乳头瘤病毒的相关性:一项横断面分析。

Human papilloma virus correlates of high grade cervical dysplasia in HIV-infected women in Mombasa, Kenya: a cross-sectional analysis.

机构信息

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.

出版信息

Virol J. 2018 Mar 27;15(1):54. doi: 10.1186/s12985-018-0961-3.


DOI:10.1186/s12985-018-0961-3
PMID:29587796
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5870930/
Abstract

BACKGROUND: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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 + .

摘要

背景: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。

方法: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。

结果: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。

结论: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。

相似文献

[1]
Human papilloma virus correlates of high grade cervical dysplasia in HIV-infected women in Mombasa, Kenya: a cross-sectional analysis.

Virol J. 2018-3-27

[2]
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[3]
Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women.

Braz J Infect Dis. 2012

[4]
Prevalence of Specific Types of Human Papiloma Virus in Cervical Intraepithelial Lesions and Cervical Cancer in Macedonian Women.

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[5]
Human Papillomavirus Types Associated with Cervical Dysplasia among HIV- and Non-HIV-Infected Women Attending Reproductive Health Clinics in Eastern Kenya.

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[6]
Associations Between Vaginal Infections and Potential High-risk and High-risk Human Papillomavirus Genotypes in Female Sex Workers in Western Kenya.

Clin Ther. 2016-12

[7]
Prevalence of and risks for cervical human papillomavirus infection and squamous intraepithelial lesions in adolescent girls: impact of infection with human immunodeficiency virus.

Arch Pediatr Adolesc Med. 2000-2

[8]
High levels of HPV-16 DNA are associated with high-grade cervical lesions in women at risk or infected with HIV.

AIDS. 2005-5-20

[9]
Association of HIV infection with distribution and viral load of HPV types in Kenya: a survey with 820 female sex workers.

BMC Infect Dis. 2010-1-26

[10]
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引用本文的文献

[1]
Syndemic Synergy of HPV, HIV, and HSV-2 for Oncogenic HPV Replication in Female Sex Workers.

Trop Med Infect Dis. 2025-6-7

[2]
Confronting the human papillomavirus-HIV intersection: Cervical cytology implications for Kenyan women living with HIV.

South Afr J HIV Med. 2023-10-27

[3]
The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis.

EClinicalMedicine. 2023-10-5

[4]
Utilisation of cervical cancer screening among women living with HIV at Kenya's national referral hospital.

South Afr J HIV Med. 2022-4-25

[5]
Detection of types of HPV among HIV-infected and HIV-uninfected Kenyan women undergoing cryotherapy or loop electrosurgical excision procedure.

Int J Gynaecol Obstet. 2020-8-18

[6]
Cervical Dysplasia, Infection, and Phylogeny of Human Papillomavirus in HIV-Infected and HIV-Uninfected Women at a Reproductive Health Clinic in Nairobi, Kenya.

Biomed Res Int. 2020

本文引用的文献

[1]
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