人类免疫缺陷病毒感染对塞内加尔西部妇女人乳头瘤病毒清除的影响。

Effect of Human Immunodeficiency Virus Infection on Human Papillomavirus Clearance Among Women in Senegal, West Africa.

机构信息

Department of Epidemiology, University of Washington, Seattle, Washington, USA.

Service des Maladies Infectieuses Centre Hospitalier National Universitaire (CHNU) de Fann, Dakar, Sénégal.

出版信息

J Infect Dis. 2023 Apr 26;227(9):1088-1096. doi: 10.1093/infdis/jiac428.

DOI:10.1093/infdis/jiac428

PMID:36314598

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10319963/

Abstract

BACKGROUND

Persistent infection with high-risk human papillomavirus (HPV) is associated with development of invasive cervical cancer.

METHODS

Longitudinal data was collected from 174 Senegalese women. We employed marginal Cox proportional hazards models to examine the effect of human immunodeficiency virus (HIV) status (HIV positive vs HIV negative) and HIV type (HIV-1 vs HIV-2 vs dual HIV-1/HIV-2) on clearance of type-specific HPV infection. Analyses were stratified by incident versus prevalent HPV infection.

RESULTS

Incident HPV infections in HIV-positive women were less likely to clear than those in HIV-negative women (adjusted hazard ratio [HR] = 0.60; 95% confidence interval [CI], .38-.94). Among HIV-positive women, HIV-2-infected women and HIV-1/2 dually infected women were more likely to clear HPV incident infections than HIV-1-infected women (HR = 1.66; 95% CI, .95-2.92 and HR = 2.17; 95% CI, 1.12-4.22, respectively). Incident HPV infections in HIV-positive women with CD4 cell count ≤500 cells/μL were less likely to clear than those in HIV-positive women with CD4 cell count >500 cells/μL (HR = 0.65; 95% CI, .42-1.01). No significant associations were observed for prevalent HPV infections.

CONCLUSIONS

HIV infection reduced the likelihood of clearance of incident HPV infection. Furthermore, among HIV-positive women, low CD4 cell count and dual HIV infection were each associated with reduced likelihood of clearance.

摘要

背景

高危型人乳头瘤病毒（HPV）持续感染与浸润性宫颈癌的发生有关。

方法

从 174 名塞内加尔妇女中收集了纵向数据。我们采用边缘 Cox 比例风险模型来研究人类免疫缺陷病毒（HIV）状态（HIV 阳性与 HIV 阴性）和 HIV 类型（HIV-1 与 HIV-2 与双重 HIV-1/HIV-2）对清除 HPV 感染的影响。分析按新发与现患 HPV 感染分层。

结果

与 HIV 阴性妇女相比，HIV 阳性妇女新发 HPV 感染更不易清除（校正风险比 [HR] = 0.60；95%置信区间 [CI]，.38-.94）。在 HIV 阳性妇女中，HIV-2 感染者和 HIV-1/2 双重感染者清除 HPV 新发感染的可能性高于 HIV-1 感染者（HR = 1.66；95%CI，.95-2.92 和 HR = 2.17；95%CI，1.12-4.22）。CD4 细胞计数≤500 个/μL 的 HIV 阳性妇女新发 HPV 感染较 CD4 细胞计数>500 个/μL 的 HIV 阳性妇女更不易清除（HR = 0.65；95%CI，.42-1.01）。未观察到现患 HPV 感染的显著相关性。