Henderson Merle, Lyons Dierdre, Beddows Simon, Cowen Miranda, Panwar Kavita, Wright Corrina, Ujetz Jacquie, Crook Ellie, Patel Hasit, Smith David, Foster Caroline, Fidler Sarah, Elliott Tamara
Imperial College London, Department of Infectious Disease, Faculty of Medicine, London, UK.
Imperial College Healthcare NHS Trust, London, UK.
HIV Med. 2025 May;26(5):709-720. doi: 10.1111/hiv.70001. Epub 2025 Feb 25.
Human papillomavirus (HPV)-associated cervical cancer risk is greater in people with HIV, although this has been at least partially attenuated by antiretroviral medication, enhanced cervical screening and HPV vaccination. People with perinatally acquired HIV may remain at higher risk due to lifelong immunosuppression and potentially reduced vaccine effectiveness. In this study in people with a cervix with perinatally acquired HIV, we explored cervical high-risk HPV (hrHPV) prevalence and HPV serostatus.
Participants were recruited from a London HIV service between 2020 and 2022. Cervical samples from those sexually active were analysed for hrHPV (Cepheid GeneXpert) and cytology, and, if abnormal, a referral was made to colposcopy. Serum samples were tested for antibodies against HPV6/11/16/18/31/33/45/52/58. A self-reported questionnaire including HPV vaccination history was completed.
Fifty-seven people were recruited with a median age of 25 years (range 18-34). Of those providing a cervical sample, 15/47 (32%) were hrHPV-positive and 12/40 (30%) had abnormal cytology; 1/17 referred for colposcopy had CIN2 (6%); 7/15 (47%) with hrHPV were below the national screening age of 24.5 years (range 19-23), and 9/15 (60%) reported previous HPV vaccination. No vaccinated participants had hrHPV16/18. Of those vaccinated, 37/39 (95%) were seropositive for HPV16 and 30/39 (77%) for HPV18. Two vaccinated participants were seronegative for HPV16/18; both had detectable HIV viral loads and CD4 counts <200 cells/μL at recruitment.
In this small observational study we identified a 32% prevalence of cervical hrHPV. Cervical screening and HPV vaccination remain vital in this group, with further data required to inform screening guidelines for this population.
人乳头瘤病毒（HPV）相关宫颈癌在HIV感染者中的发病风险更高，尽管抗逆转录病毒药物治疗、强化宫颈筛查和HPV疫苗接种已至少部分降低了这一风险。围生期感染HIV者可能因终身免疫抑制以及疫苗效力可能降低而仍处于较高风险中。在这项针对围生期感染HIV的宫颈人群的研究中，我们探究了宫颈高危型HPV（hrHPV）的流行率及HPV血清学状态。
2020年至2022年间从伦敦一家HIV服务机构招募参与者。对有性活动者的宫颈样本进行hrHPV（赛沛GeneXpert）检测和细胞学检查，若结果异常，则转诊至阴道镜检查。检测血清样本中针对HPV6/11/16/18/31/33/45/52/58的抗体。完成一份包括HPV疫苗接种史的自我报告问卷。
招募了57人，中位年龄为25岁（范围18 - 34岁）。在提供宫颈样本的人中，15/47（32%）为hrHPV阳性，12/40（30%）细胞学检查异常；转诊至阴道镜检查的1/17中有1例为CIN2（6%）；15例hrHPV感染者中有7/15（47%）低于全国筛查年龄24.5岁（范围19 - 23岁），9/15（60%）报告曾接种HPV疫苗。接种疫苗者中无人感染hrHPV16/18。在接种疫苗者中，37/39（95%）HPV16血清学阳性，30/39（77%）HPV18血清学阳性。两名接种疫苗者HPV16/18血清学阴性；两人在招募时HIV病毒载量均可检测到且CD4细胞计数<200个/μL。
在这项小型观察性研究中，我们发现宫颈hrHPV流行率为32%。宫颈筛查和HPV疫苗接种在该人群中仍然至关重要，需要更多数据来为该人群的筛查指南提供依据。
