Kangethe James M, Gichuhi Stephen, Odari Eddy, Pintye Jillian, Mutai Kenneth, Abdullahi Leila, Maiyo Alex, Mureithi Marianne W
Consortium for Advanced Research Training in Africa (CARTA), Nairobi, Kenya.
Department of Medical Microbiology and Immunology, Faculty of Health Sciences, University of Nairobi, Kenya.
South Afr J HIV Med. 2023 Oct 27;24(1):1508. doi: 10.4102/sajhivmed.v24i1.1508. eCollection 2023.
High-risk human papillomavirus (HR-HPV) is the primary cause of cervical cancer, leading to over 311 000 global deaths, mainly in low- and middle-income countries. Kenyan women living with HIV (WLHIV) face a disproportionate burden of HR-HPV.
We determined the prevalence of HR-HPV infections and their association with cervical cytology findings among Kenyan WLHIV.
We conducted a cross-sectional study among WLHIV attending the HIV care and treatment clinic at the Kenyatta National Hospital (KNH), Kenya's national referral hospital. Study nurses collected a cervical sample with a cytobrush for HR-HPV genotyping using Gene Xpert assays and HPV Genotypes 14 Real-TM Quant V67-100FRT. Bivariate analysis explored the associations.
We enrolled 647 WLHIV (mean age of 42.8 years), with 97.2% on antiretroviral therapy (ART) and 79% with a suppressed viral load (< 50 copies/mL plasma). The prevalence of any and vaccine-preventable HR-HPV was 34.6% and 29.4%, respectively, with HPV 52 being the most common genotype (13.4%). Among WLHIV with HR-HPV infections, 21.4% had abnormal cervical cytology. Women with multiple HR-HPV infections were more likely to have abnormal cytology compared to those with single HR-HPV infections (34.9 vs 9.3%, adjusted odds ratio [aOR] = 6.2, 95% confidence interval [CI]: 2.7-14.1, = 0.001). Women with HR-HPV infection (single or multiple) were more likely to be on the second-line ART regimen compared to those without HR-HPV infections (53.1% vs 46.7%, aOR = 2.3, 95% CI: 1.3-4.1, = 0.005).
Among WLHIV at KNH, abnormal cytology was common and more frequent among women with multiple HR-HPV infections.
高危型人乳头瘤病毒（HR-HPV）是宫颈癌的主要病因，导致全球每年超过31.1万人死亡，主要集中在低收入和中等收入国家。肯尼亚感染艾滋病毒的女性（WLHIV）面临着不成比例的HR-HPV负担。
我们确定了肯尼亚WLHIV中HR-HPV感染的流行率及其与宫颈细胞学检查结果的关联。
我们在肯尼亚国家转诊医院肯雅塔国家医院（KNH）的艾滋病毒护理和治疗诊所对WLHIV进行了一项横断面研究。研究护士使用Gene Xpert检测和HPV Genotypes 14 Real-TM Quant V67-100FRT，用细胞刷采集宫颈样本进行HR-HPV基因分型。双变量分析探讨了两者之间的关联。
我们纳入了647名WLHIV（平均年龄42.8岁），其中97.2%正在接受抗逆转录病毒治疗（ART），79%的病毒载量得到抑制（血浆中<50拷贝/mL）。任何类型和可通过疫苗预防的HR-HPV的流行率分别为34.6%和29.4%，其中HPV 52是最常见的基因型（13.4%）。在感染HR-HPV的WLHIV中，21.4%的宫颈细胞学检查结果异常。与单一HR-HPV感染的女性相比，多重HR-HPV感染的女性更有可能出现细胞学异常（34.9%对9.3%，调整后的优势比[aOR]=6.2，95%置信区间[CI]：2.7-14.1，P=0.001）。与未感染HR-HPV的女性相比，感染HR-HPV（单一或多重）的女性更有可能接受二线ART治疗方案（53.1%对46.7%，aOR=2.3，95%CI：1.3-4.1，P=0.005）。
在KNH的WLHIV中，细胞学异常很常见，在多重HR-HPV感染的女性中更为频繁。
