Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana.
Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana.
Int J Cancer. 2020 Mar 15;146(6):1667-1673. doi: 10.1002/ijc.32581. Epub 2019 Aug 2.
Cervical cancer remains a significant cause of morbidity and mortality in women worldwide and is the leading cause of cancer-related death in Botswana. It is well established that women with HIV have a higher risk of persistent HPV infection leading to cervical cancer. We assessed HPV prevalence and genotype distribution in 126 tissue specimens from confirmed invasive cervical cancer cases using Abbott real-time PCR assay. Overall, 88 (69.8%) women were HIV-infected. Fifty-seven (64.8%) of the HIV-infected women had a baseline CD4 count ≥350 cells/μl, and 82 (93.2%) were on antiretroviral therapy at the time of cervical cancer diagnosis. The median age of HIV-infected patients was significantly younger than that of HIV-uninfected patients (p < 0.001). HPV DNA was detected in all of 126 (100%) of tissues analyzed in our study. The HPV genotypes identified included the HPV-16 (75.4%), HPV-18 (28.6%) and other high-risk (hr) HPV genotypes (16.7%). HIV infection was positively associated with the presence of the HPV-16 genotype (p = 0.036), but not with HPV-18 or with other high-risk (hr)-HPV genotypes. Thirty-three percent of the patients had multiple hr-HPV genotypes, with higher rates in HIV-infected women. These results highlight the importance and potential impact of large-scale HPV vaccination programs covering HPV-16 and HPV-18 genotypes in countries like Botswana with high burden of HIV infection.
宫颈癌仍然是全世界女性发病率和死亡率的一个重要原因，也是博茨瓦纳癌症相关死亡的主要原因。众所周知，感染 HIV 的女性持续感染 HPV 的风险更高，从而导致宫颈癌。我们使用 Abbott 实时 PCR 检测法评估了 126 份确诊为浸润性宫颈癌组织标本中的 HPV 流行率和基因型分布。总体而言，88 名（69.8%）女性感染了 HIV。57 名（64.8%）感染 HIV 的女性基线 CD4 计数≥350 个/μl，82 名（93.2%）在诊断宫颈癌时正在接受抗逆转录病毒治疗。感染 HIV 的患者的中位年龄明显低于未感染 HIV 的患者（p<0.001）。在我们的研究中，分析的 126 份组织中均检测到 HPV DNA。鉴定出的 HPV 基因型包括 HPV-16（75.4%）、HPV-18（28.6%）和其他高危（hr）HPV 基因型（16.7%）。HPV 感染与 HPV-16 基因型的存在呈正相关（p=0.036），但与 HPV-18 或其他高危（hr）-HPV 基因型无关。33%的患者存在多种 hr-HPV 基因型，感染 HIV 的女性中该比率更高。这些结果突出了在像博茨瓦纳这样 HIV 感染负担沉重的国家开展大规模 HPV 疫苗接种计划以覆盖 HPV-16 和 HPV-18 基因型的重要性和潜在影响。
