Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil.
Department of Nursing, Federal University of Sergipe, Aracaju, Brazil.
Expert Rev Anti Infect Ther. 2022 Apr;20(4):611-620. doi: 10.1080/14787210.2022.1990039. Epub 2021 Oct 22.
We systematically investigated the prevalence of HPV, high-risk HPV and its genotypes in women living with human immunodeficiency virus (WLHIV) in Brazil.
A systematic search was performed up to 15 December 2020. We included studies that used molecular methods for HPV detection in cervical samples and reported the prevalence of HPV in Brazilian WLHIV. The pooled prevalence of HPV, high-risk HPV (HR HPV) and HPV types and their 95% confidence interval (CI) were estimated. Subgroup analyses and meta-regression were conducted.
Thity-seven studies accounting for 8,436 WLHIV were included. The pooled HPV prevalence was 62% (95%CI 55-68%; I = 96.98%; P < 0.001). Prevalence of high-risk HPV was 40% (95%CI, 54-68%; I = 94.23%; P < 0.001). We found a wide variety of high-risk HPV genotypes. The high-risk HPV types most reported were HPV 16 (16%) and HPV 58 (6%). We found an increasing ratio of positivity from normal cervix to cancer. There were different factors associated with high-risk HPV, with low CD4+ count the most frequent.
The increase in the ratio of high-risk HPV positivity from normal cervix to carcinogenic lesions highlights the need to implement well-established testing for high-risk HPV in this population.
我们系统地调查了巴西艾滋病毒感染者（WLHIV）中 HPV、高危型 HPV 及其基因型的流行情况。
系统检索截至 2020 年 12 月 15 日的文献。我们纳入了使用分子方法检测宫颈样本中 HPV 并报告巴西 WLHIV 中 HPV 流行率的研究。估计 HPV、高危型 HPV（HR HPV）和 HPV 型别的总流行率及其 95%置信区间（CI）。进行了亚组分析和荟萃回归。
共有 37 项研究纳入了 8436 名 WLHIV。HPV 的总流行率为 62%（95%CI 55-68%；I=96.98%；P<0.001）。高危型 HPV 的流行率为 40%（95%CI，54-68%；I=94.23%；P<0.001）。我们发现高危型 HPV 基因型种类繁多。报告最多的高危型 HPV 类型是 HPV 16（16%）和 HPV 58（6%）。我们发现从正常宫颈到癌症病变的 HPV 阳性率呈上升趋势。有不同的因素与高危型 HPV 相关，其中 CD4+计数低最为常见。
从正常宫颈到癌前病变的高危型 HPV 阳性率的增加突出表明，需要在该人群中实施经过充分验证的高危型 HPV 检测。
