Mboumba-Mboumba Marcelle, Mouinga-Ondeme Augustin, Moussavou-Boundzanga Pamela, Engone-Ondo Jeordy Dimitri, Mounanga Mourimarodi Roseanne, Diane Abdoulaye, Ognari Ayoumi Christ, Bélec Laurent, Mboumba Bouassa Ralph-Sydney, Mfouo-Tynga Ivan
Unité des Infections Rétrovirales et Pathologies Associées, Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville BP 769, Gabon.
Ecole Doctorale Régionale (EDR) d'Afrique Centrale en Infectiologie Tropicale, Franceville BP 876, Gabon.
Diseases. 2025 Aug 14;13(8):260. doi: 10.3390/diseases13080260.
Women living with human immunodeficiency virus (WLWH) have a six-fold higher risk of developing cervical cancer associated with high-risk human Papillomavirus (HR-HPV) than HIV-negative women. We herein assessed HR-HPV genotype distribution and plasma levels of the cancer antigen 125 (CA-125) in WLWH in a rural town in Gabon, in Central Africa. Adult WLWH attending the local HIV outpatient center were prospectively enrolled and underwent cervical visual inspection and cervicovaginal and blood sampling. HIV RNA load and CA-125 levels were measured from plasma using the Cepheid Xpert HIV-1 Viral Load kit and BioMérieux VIDAS CA-125 II assay, respectively. HPV detection and genotyping were performed via a nested polymerase chain reaction (MY09/11 and GP5+/6+), followed by sequencing. Fifty-eight WLWH (median age: 52 years) were enrolled. Median CD4 count was 547 cells/µL (IQR: 412.5-737.5) and HIV RNA load 4.88 Log copies/mL (IQR: 3.79-5.49). HPV prevalence was 68.96%, with HR-HPV detected in 41.37% of women. Among HR-HPV-positive samples, 87.5% (21/24) were genotypes targeted by the Gardasil vaccine, while 12.5% (3/24) were non-vaccine types. Predominant HR-HPV types included HPV-16 (13.8%), HPV-33 (10.34%), HPV-35 (5.17%), HPV-31, and HPV-58 (3.45%). Most participants had normal cervical cytology (62.07%), and a minority (14.29%) had elevated CA-125 levels, with no correlation to cytological abnormalities. In the hinterland of Gabon, WLWH are facing an unsuspected yet substantial burden of cervical HR-HPV infection and a neglected risk for cervical cancer. Strengthening cervical cancer prevention through targeted HPV vaccination, sexual education, and accessible screening strategies will help in mitigating associated risk.
感染人类免疫缺陷病毒（HIV）的女性（WLWH）患与高危型人乳头瘤病毒（HR-HPV）相关宫颈癌的风险比未感染HIV的女性高6倍。我们在此评估了中非加蓬一个乡村城镇中WLWH的HR-HPV基因型分布及癌抗原125（CA-125）的血浆水平。前瞻性纳入了在当地HIV门诊中心就诊的成年WLWH，并对其进行宫颈视诊、宫颈阴道取样及血液取样。分别使用赛沛Xpert HIV-1病毒载量检测试剂盒和生物梅里埃VIDAS CA-125 II检测法测定血浆中的HIV RNA载量和CA-125水平。通过巢式聚合酶链反应（MY09/11和GP5+/6+）进行HPV检测和基因分型，随后进行测序。共纳入58例WLWH（中位年龄：52岁）。CD4细胞计数中位数为547个/µL（四分位间距：412.5 - 737.5），HIV RNA载量为4.88 Log拷贝/mL（四分位间距：3.79 - 5.49）。HPV感染率为68.96%，41.37%的女性检测到HR-HPV。在HR-HPV阳性样本中，87.5%（21/24）为Gardasil疫苗所针对的基因型，而12.5%（3/24）为非疫苗型。主要的HR-HPV类型包括HPV-16（13.8%）、HPV-33（10.34%）、HPV-35（5.17%）、HPV-31和HPV-58（3.45%）。大多数参与者宫颈细胞学检查正常（62.07%），少数（14.29%）CA-125水平升高，且与细胞学异常无相关性。在加蓬内地，WLWH面临着未被察觉但相当严重的宫颈HR-HPV感染负担以及被忽视的宫颈癌风险。通过有针对性的HPV疫苗接种、性教育和可及的筛查策略加强宫颈癌预防将有助于降低相关风险。
