Department of Health Management Center, Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.
J Med Virol. 2023 Jun;95(6):e28891. doi: 10.1002/jmv.28891.
Previous studies reported human immunodeficiency virus (HIV) could enhance human papillomavirus (HPV)-induced cervical cancer. Therefore, the burden of cervical cancer associated with HIV across different regions and time periods need to be assessed. We aim to investigate the global burden of cervical cancer associated with HIV infection. Age standardized rates (ASRs) of cervical cancer disability-adjusted life-years (DALYs) in females (≥15 years old) were calculated by standardization, according the age-specific DALYs numbers extracted from GBD data set 2019. Population attributable fractions was calculated by combining the published risk ratio, with the HIV prevalence (≥15 years old) from Joint United Nations Programme on HIV and AIDS (UNAIDS), and transferred to estimate the HIV-associated cervical cancer burden. Expected annual percentage changes (EAPCs) was calculated to describe the temporal trend of ASR from 1990 to 2019. Pearson correlation analysis were conducted to assess the correlation between the ASR or EAPCs and the socio-demographic index. The worldwide DALYs ASR caused by HIV-associated cervical cancer rose from 3.78 (95% confidence interval [CI]: 2.19-5.56) in 1990 to 9.50 (95% CI: 5.66-13.79) in 2019 per 100k population. In 2019, the region with the greatest burden was Eastern and Southern Africa, with the highest DALYs of 273 900 (95% CI: 149 100-476 400) and ASR of 254.44 per 100k population (95% CI: 168.86-329.28). Notably, the Eastern Europe and Central Asia regions had the highest EAPC (14.07%) of HIV-associated DALYs ASR. Women in Eastern and Southern Africa experience the greatest burden of HIV-associated cervical cancer, while the Eastern Europe and Central Asia regions had witnessed the largest increase over the last 30 years. Prioritize the promotion of HPV vaccination and cervical cancer screening for women living with HIV were crucial in these regions.
先前的研究报告称，人类免疫缺陷病毒（HIV）会增强人乳头瘤病毒（HPV）引发的宫颈癌。因此，需要评估不同地区和时间段与 HIV 相关的宫颈癌负担。我们旨在研究与 HIV 感染相关的宫颈癌全球负担。通过标准化，根据从 GBD 2019 数据集提取的特定年龄 DALYs 数量，计算女性（≥15 岁）宫颈癌残疾调整生命年（DALYs）的年龄标准化率（ASR）。通过结合已发表的风险比，以及联合国艾滋病规划署（UNAIDS）的 HIV 流行率（≥15 岁），计算人群归因分数，并将其转化为估计 HIV 相关宫颈癌负担。预期年度百分比变化（EAPC）用于描述 1990 年至 2019 年 ASR 的时间趋势。进行 Pearson 相关分析，以评估 ASR 或 EAPC 与社会人口指数之间的相关性。1990 年，与 HIV 相关的宫颈癌导致的全球 DALYs ASR 为每 10 万人 3.78（95%置信区间 [CI]：2.19-5.56），到 2019 年上升至每 10 万人 9.50（95%CI：5.66-13.79）。2019 年，负担最重的地区是东非和南非，DALYs 最高为 273900（95%CI：149100-476400），ASR 为每 10 万人 254.44（95%CI：168.86-329.28）。值得注意的是，东欧和中亚地区与 HIV 相关的 DALYs ASR 的 EAPC 最高（14.07%）。东非和南非的妇女承受着与 HIV 相关的宫颈癌的最大负担，而东欧和中亚地区在过去 30 年中经历了最大的增长。在这些地区，优先考虑促进 HIV 感染者的 HPV 疫苗接种和宫颈癌筛查至关重要。
