Infectious Diseases Department, CHU de Martinique, Fort-de-France, France.
Université des Antilles, Fort-de-France, France.
PLoS One. 2019 Sep 4;14(9):e0221334. doi: 10.1371/journal.pone.0221334. eCollection 2019.
An association between HIV infection and cervical cancer, a major public health issue worldwide, has been reported. The aim of this study was to estimate the prevalence of human papillomavirus (HPV) infection and the distribution of HPV genotypes in HIV-infected women living in French Antilles and Guiana and to determine HIV-related characteristics associated with HPV infection. This cross-sectional study included 439 HIV-infected women who were followed between January 2011 and May 2014. Variables related to HIV infections were collected, and cervical samples were analysed to determine HPV genotypes. The median age of the population was 46 years. Estimated prevalence of HPV and high-risk (HR)-HPV infection were 50.1% IC95 [45.4-54.7] and 42% IC95 [37.3-46.6], respectively. HR-HPV 16, 52, 53 or intermediate risk-HPV-68 were found in 25% to 30% of the HPV-infected patients. Gynaecological screening revealed abnormal cervical smear in 24% and 42% of HR-HPV-negative and HPV-positive women, respectively (p = 0.003). Approximately 90% of women were on antiretroviral therapy (ART). Demographic characteristics associated with a higher prevalence of HPV infection included alcohol consumption. Regarding HIV-related characteristics, current therapy on ART, its duration, and undetectable plasma concentrations of RNA-HIV1 were associated with a lower risk of HPV infection. Infection rate with HR-HPV was higher than what is commonly reported in HIV-negative women worldwide and was more likely in women with incomplete HIV suppression. These results highlight the need for supporting adherence to ART, cervical cytology, HPV testing and HPV vaccination.
HIV 感染与宫颈癌的相关性已被报道,宫颈癌是全球主要的公共卫生问题之一。本研究旨在评估生活在法属安的列斯群岛和圭亚那的 HIV 感染妇女中人乳头瘤病毒(HPV)感染的流行率以及 HPV 基因型的分布,并确定与 HPV 感染相关的 HIV 相关特征。这项横断面研究纳入了 439 名于 2011 年 1 月至 2014 年 5 月期间接受随访的 HIV 感染妇女。收集了与 HIV 感染相关的变量,并对宫颈样本进行了分析以确定 HPV 基因型。研究人群的中位年龄为 46 岁。HPV 和高危(HR)-HPV 感染的估计流行率分别为 50.1%(95%CI:45.4-54.7)和 42%(95%CI:37.3-46.6)。在感染 HPV 的患者中,发现 HR-HPV 16、52、53 或中危 HPV-68 分别占 25%至 30%。在 HR-HPV 阴性和 HPV 阳性的女性中,妇科筛查分别发现 24%和 42%的宫颈涂片异常(p = 0.003)。约 90%的妇女正在接受抗逆转录病毒治疗(ART)。与 HPV 感染率较高相关的人口统计学特征包括饮酒。关于 HIV 相关特征,目前接受 ART 治疗、治疗持续时间以及 HIV1 血浆 RNA 无法检测与 HPV 感染风险降低相关。HR-HPV 感染率高于全球 HIV 阴性妇女的常见报告值,并且在 HIV 抑制不完全的女性中更常见。这些结果强调了需要支持坚持接受 ART、宫颈细胞学检查、HPV 检测和 HPV 疫苗接种。