Obstetrics & Gynecology, University of British Columbia, Vancouver, BC, CA.
Canadian HIV Trials Network, Vancouver, BC, CA.
Int J STD AIDS. 2023 May;34(6):402-407. doi: 10.1177/09564624231154298. Epub 2023 Jan 26.
Several co-factors for HPV oncogenesis have been proposed, including co-infection with HSV-2. We assessed the relationship between HSV-2 infection and HPV-related outcomes in quadrivalent HPV-vaccinated (qHPV) women living with HIV (WLWH).
In this multi-site study of immunogenicity and efficacy of the qHPV vaccine in WLWH, visits took place at months -3, 0, 2, 6, 12, 18, 24, and annually thereafter. Participants provided clinical data and cervico-vaginal swabs for HPV DNA detection; baseline serum was tested for HSV-2 type-specific antibodies. We used non-parametric statistics to compare HPV-related outcomes by HSV-2 serostatus and use of anti-HSV medication.
151 baseline serum samples underwent HSV-2 testing. At baseline, median age was 39 years, median CD4 count was 500 cells/mm, and 70% had an HIV viral load of <50 copies/mL. Baseline HSV-2 seroprevalence was 76.2%. HSV-2 seropositivity was associated with increased age ( = 0.006). Controlling for age and median CD4 count, HSV-2 seropositivity was not associated with HPV incidence, persistence, and precancerous lesions. The use of anti-HSV medications was associated with higher odds of HSIL cytology (OR = 3.35, 95% CI = 1.03,11.26) and a greater number of HPV types detected (OR = 1.18, 95% CI = 1.00,1.39). Results were similar in sensitivity analyses using an index value of 3.5. The presence of HSV lesions during the study was not associated with HPV outcomes.
HSV-2 seropositivity was common in this cohort of WLWH in Canada but was not associated with multiple measures of HPV incidence, persistence, and precancerous lesions. However, the use of anti-HSV medications was associated with HSIL cytology and number of HPV types detected.
已提出 HPV 致癌的几种共同因素，包括与单纯疱疹病毒 2 型（HSV-2）的合并感染。我们评估了 HSV-2 感染与在感染人类免疫缺陷病毒（HIV）的妇女（WHW）中接种四价 HPV 疫苗（qHPV）后的 HPV 相关结局之间的关系。
在这项针对 WHW 中 qHPV 疫苗的免疫原性和疗效的多中心研究中，在 -3、0、2、6、12、18、24 个月和此后每年进行访视。参与者提供临床数据和宫颈阴道拭子进行 HPV DNA 检测；基线血清检测 HSV-2 型特异性抗体。我们使用非参数统计比较 HSV-2 血清学状态和使用抗 HSV 药物与 HPV 相关结局之间的关系。
151 份基线血清样本进行了 HSV-2 检测。基线时，中位年龄为 39 岁，中位 CD4 计数为 500 个细胞/mm，70%的 HIV 病毒载量<50 拷贝/mL。基线 HSV-2 血清流行率为 76.2%。HSV-2 血清阳性与年龄增加有关（=0.006）。在控制年龄和中位 CD4 计数后，HSV-2 血清阳性与 HPV 发病率、持续性和癌前病变无关。抗 HSV 药物的使用与 HSIL 细胞学的更高几率相关（OR=3.35，95%CI=1.03，11.26）和更多 HPV 类型的检出（OR=1.18，95%CI=1.00，1.39）。使用 3.5 的指数值进行的敏感性分析结果相似。研究期间 HSV 病变的存在与 HPV 结局无关。
在加拿大的这个 WHW 队列中，HSV-2 血清阳性很常见，但与 HPV 发病率、持续性和癌前病变的多个指标无关。然而，抗 HSV 药物的使用与 HSIL 细胞学和 HPV 类型的检出数量相关。
