Williams A B, Darragh T M, Vranizan K, Ochia C, Moss A R, Palefsky J M
Adult Health Division, Yale School of Nursing, New Haven, Connecticut.
Obstet Gynecol. 1994 Feb;83(2):205-11.
To determine the prevalence of anal and cervical infection with human papillomavirus (HPV) and cytologic abnormalities and to examine the relation among HPV infection, cytologic abnormalities, and human immunodeficiency virus (HIV) serostatus.
Anal and cervical Papanicolaou tests, HPV dot blot tests, and polymerase chain reaction (PCR) tests for HPV were performed concurrently in a cross-sectional study of 114 women enrolled in a community-based study of HIV infection.
Cervical HPV infection was associated with HIV serostatus by both dot blot (odds ratio [OR] 4.2, 95% confidence interval [CI] 1-25) and PCR (OR 8.9, 95% CI 3.2-27). Anal HPV infection was twice as frequent as cervical and also was associated with HIV by dot blot (OR 2.5, 95% CI 0.9-7) and PCR (OR 2.6, 95% CI 1.03-6.8). Eleven percent (11 of 96) of cervical cytologies were abnormal and were associated with HIV (OR 6.1, 95% CI 1.2-60.5). Fourteen percent (15 of 109) of anal cytologies were abnormal and were associated with HIV (OR 3.4, 95% CI 0.9-15.5). Among HIV-seropositive women, epithelial abnormalities were associated with lower mean CD4+ cell counts when HPV DNA was detected by dot blot at either the cervix (P = .04) or anus (P = .009). Independent predictors for cervical epithelial abnormalities were HPV DNA positivity by dot blot (OR 32.1, 95% CI 2.9-353.9) and positive HIV serostatus with CD4+ cell count below 250 cells/mm3 (OR 126.8, 95% CI 7.5-2132.6).
Human papillomavirus-associated epithelial abnormalities are associated with immune suppression among HIV-infected women. Anal HPV infection and disease is at least as common as cervical infection and disease among HIV-seropositive women.
确定人乳头瘤病毒（HPV）肛门和宫颈感染及细胞学异常的患病率，并研究HPV感染、细胞学异常与人类免疫缺陷病毒（HIV）血清学状态之间的关系。
在一项针对114名参与基于社区的HIV感染研究的女性的横断面研究中，同时进行了肛门和宫颈巴氏试验、HPV斑点印迹试验以及HPV聚合酶链反应（PCR）检测。
通过斑点印迹法（优势比[OR]4.2，95%置信区间[CI]1 - 25）和PCR法（OR 8.9，95% CI 3.2 - 27），宫颈HPV感染均与HIV血清学状态相关。肛门HPV感染的频率是宫颈的两倍，通过斑点印迹法（OR 2.5，95% CI 0.9 - 7）和PCR法（OR 2.6，95% CI 1.03 - 6.8）也与HIV相关。96例宫颈细胞学检查中有11%（11例）异常，且与HIV相关（OR 6.1，95% CI 1.2 - 60.5）。109例肛门细胞学检查中有14%（15例）异常，且与HIV相关（OR 3.4，95% CI 0.9 - 15.5）。在HIV血清学阳性女性中，当通过斑点印迹法在宫颈（P = 0.04）或肛门（P = 0.009）检测到HPV DNA时，上皮异常与较低的平均CD4 +细胞计数相关。宫颈上皮异常的独立预测因素是斑点印迹法检测HPV DNA阳性（OR 32.1，95% CI 2.9 - 353.9）以及HIV血清学阳性且CD4 +细胞计数低于250个细胞/mm³（OR 126.8，95% CI 7.5 - 2132.6）。
在HIV感染女性中，HPV相关的上皮异常与免疫抑制相关。在HIV血清学阳性女性中，肛门HPV感染及疾病至少与宫颈感染及疾病一样常见。
