Diagnostic value of human papillomavirus (HPV) 16 and HPV18 viral loads for the detection of high-grade cervical intraepithelial neoplasia (CIN2+) in a cohort of African women living with HIV
Diagnostic value of human papillomavirus (HPV) 16 and HPV18 viral loads for the detection of high-grade cervical intraepithelial neoplasia (CIN2+) in a cohort of African women living with HIV
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DOI：
10.1016/j.jcv.2018.01.006
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发表时间：
2018-02-01
影响因子：
8.8
通讯作者：
Didelot, Marie-Noelle
中科院分区：
文献类型：
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作者：
Segondy, Michel;Ngou, Jean;Didelot, Marie-Noelle
背景：携带艾滋病毒(WLHIV)的非洲妇女患宫颈癌的风险很高，但很少进行充分的筛查。目的：探讨HPV16和HPV18病毒载量在非洲WLHIV队列中的诊断价值。设计：从245例HPV16和/和HPV18阳性的非洲WLHIV阳性宫颈标本中，通过实时定量聚合酶链式反应(Real-time PCR)定量检测宫颈标本中的HPV16和HPV18病毒载量。结果：CIN2+组的HPV16型(p<；0.0001)和HPV18型(p=0.03)的病毒载量均高于CIN2+组。HPV16病毒载量/1000细胞检测CIN2+的敏感度和特异度分别为93.5%(95%CI：81.7~98.3%)和74.1%(95%CI：66.3~80.6%)；HPV18病毒载量=1.63对数拷贝/1000细胞检测CIN2+的敏感度和特异度分别为59.1%(95%CI：38.7~76.7%)和66.9%(95%CI：58.8~74.1%)。高基线HPV16病毒载量与终末期CIN2+的持续或进展显著相关；HPV18则未观察到这些结果。结论：HPV16病毒载量是非洲WLHIV患者CIN2+的一个强有力的标志物。HPV18病毒载量在这一人群中的诊断价值较低。
Background: African women living with HIV (WLHIV) are at high risk of cervical cancer but rarely adequately screened. Better strategies enabling identification of WLHIV with high-grade cervical intraepithelial lesions (CIN2+) are required.Objectives: To investigate the diagnostic value of HPV16 and HPV18 viral loads in a cohort of African WLHIV.Design: HPV16 and HPV18 viral loads were determined by quantitation of the E6 gene DNA by real-time PCR in cervical specimens collected at baseline and endline (16 months) from 245 African WLHIV positive for HPV16 or/and HPV18. Cervical biopsies were graded using the histopathological CIN classification.Results: Women with CIN2+ had higher viral load for HPV16 (p < 0.0001) or HPV18 (p = 0.03) than those without CIN2+. HPV16 viral load >= 3.59 log copies/1000 cells detected CIN2+ with sensitivity and specificity of 93.5% (95% CI: 81.7-98.3%) and 74.1% (95% CI: 66.3-80.6%), respectively, whereas HPV18 viral load >= 1.63 log copies/1000 cells detected CIN2+ with sensitivity and specificity of 59.1% (95% CI: 38.7-76.7%) and 66.9% (95% CI: 58.8-74.1%), respectively. A high baseline HPV16 viral load was significantly associated with persistence of, or progression to CIN2+ at endline; these findings were not observed for HPV18.Conclusions: HPV16 viral load is a powerful marker of CIN2+ in African WLHIV. HPV18 viral load is of lower diagnostic value in this population.