Relationship between smoking and human papillomavirus infections in HIV-infected and -uninfected women
Relationship between smoking and human papillomavirus infections in HIV-infected and -uninfected women
复制标题
DOI：
10.1086/383479
复制
发表时间：
2004-05-15
影响因子：
6.4
通讯作者：
Anastos, K
中科院分区：
文献类型：
--
作者：
Minkoff, H;Feldman, JG;Anastos, K
背景。吸烟可能会增加患宫颈癌的风险，宫颈癌是一种与人乳头瘤病毒 (HPV) 感染有关的疾病。然而，人们对吸烟对 HPV 自然史的影响知之甚少，尤其是在同时感染人类免疫缺陷病毒 (HIV) 的女性中。每 6 个月对感染 HIV 的 (n = 1797) 和未感染 HIV (n = 496) 的女性进行一次特定型 HPV DNA 评估。自我报告吸烟状况。协变量包括年龄、胎次、性行为、HIV 载量、CD4(+) T 细胞计数和抗逆转录病毒治疗。结果。吸烟与 HIV 感染女性基线 HPV 患病率呈正相关 (P = .002)，并且与特定类型 HPV 检测显着相关（例如 18 型，比值比 [OR]，2.45；95% 置信区间 [CI]，1.86 - 3.22）。在 Cox 模型中，HPV 检测与 HIV 感染女性吸烟显着相关（相对危险 [RH]，1.33；95% CI，1.10 - 1.60；P = 0.003），但 HPV 持续性则不然（RH，0.97；95% CI，80 - 1.16；）。由于发病率较高，吸烟者感染持续性 HPV 的总体可能性较高（OR，1.39；95% CI，1.05 - 1.86；P = .023）。结论。在感染 HIV 的女性中，吸烟与 HPV 感染的患病率和发病率显着升高相关。 HIV 感染期间吸烟可能会改变 HPV 感染的自然史并增加患宫颈疾病的风险。
Background. Smoking may increase the risk of cervical cancer, a disease that is related to human papillomavirus (HPV) infection. However, the effects of smoking on the natural history of HPV are poorly understood, especially in women coinfected with human immunodeficiency virus (HIV).Methods. HIV-infected (n = 1797) and HIV-uninfected (n = 496) women were assessed every 6 months for type-specific HPV DNA. Smoking status was self-reported. Covariates included age, parity, sexual behavior, HIV load, CD4(+) T cell count, and antiretroviral therapy.Results. Smoking was positively associated with HPV prevalence at baseline in HIV-infected women (P = .002) and was significantly associated with type-specific HPV detection (e.g., type 18, odds ratio [OR], 2.45; 95% confidence interval [CI], 1.86 - 3.22). In Cox models, detection of HPV was significantly associated with smoking in HIV-infected women (relative hazard [RH], 1.33; 95% CI, 1.10 - 1.60; P = .003), but HPV persistence was not (RH, 0.97; 95% CI, 80 - 1.16;). The overall likelihood of acquiring persistent HPV was higher in smokers (OR, 1.39; 95% CI, 1.05 - 1.86; P = .023) because of greater incidence.Conclusions. Among HIV-infected women, smoking is associated with a significantly higher prevalence and incidence of HPV infection. Smoking during HIV infection may alter the natural history of HPV infection and increase the risk of cervical disease.