Department of Infectious Diseases, Hvidovre Hospital, Kettegaards Allé 30, 2650, Hvidovre, Denmark.
Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark.
BMC Infect Dis. 2019 Aug 22;19(1):740. doi: 10.1186/s12879-019-4377-5.
Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark.
From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL.
Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)).
This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.
感染人类免疫缺陷病毒（HIV）的女性（WLWH）持续性高危型人乳头瘤病毒（hrHPV）感染和宫颈癌的发病率较高。本研究旨在评估丹麦 WLWH 人群中 hrHPV 基因型分布、特定型别 hrHPV 持续性感染的危险因素，以及高级别鳞状上皮内病变或更高级别病变（≥HSIL）。
从前瞻性 HIV、丹麦女性宫颈异常和感染研究（SHADE）中，我们确定了在研究期间（2011-2014 年）hrHPV 检测阳性的 WLWH。HIV 人口统计学数据从丹麦 HIV 队列研究中获取，病理学结果从丹麦病理学数据库中获取。采用 logistic 回归分析鉴定与持续性 hrHPV 感染（首次 hrHPV 阳性后一至两年两次样本检测出相同 hrHPV 型阳性）和≥HSIL 相关的危险因素。
在 71 例 WLWH 中，31 例（43.7%）存在持续性 hrHPV 感染。优势型别 HPV58、52、51 和 35，最常见的持续性感染型别 HPV52、33 和 31。CD4<350 个细胞/μL 预测特定型别 hrHPV 持续性感染（调整后的 OR 4.36，95%CI：1.18-16.04），而 AIDS 病史预测≥HSIL（调整后的 OR 8.55，95%CI：1.21-60.28）。
本项在丹麦对治疗良好的 WLWH 进行的前瞻性队列研究发现，持续性 hrHPV 感染率较高，主要为非 16/18 型别 hrHPV 感染。CD4 计数<350 个细胞/μL 预测 hrHPV 持续性感染，而 AIDS 病史预测≥HSIL。
