Distribution of Human Papillomavirus Genotypes among HIV-Positive and HIV-Negative Women in Cape Town, South Africa.
Distribution of Human Papillomavirus Genotypes among HIV-Positive and HIV-Negative Women in Cape Town, South Africa.
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DOI：
10.3389/fonc.2014.00048
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发表时间：
2014
影响因子：
4.7
通讯作者：
Wright TC Jr
中科院分区：
文献类型：
--
作者：
McDonald AC;Tergas AI;Kuhn L;Denny L;Wright TC Jr
目的：已知艾滋病病毒（HIV）阳性女性感染人乳头瘤病毒（HPV）及其相关宫颈病变的风险较高。在此，我们描述了南非HIV阳性和阴性女性中HPV基因型的流行情况和分布，包括有和没有宫颈上皮内瘤变（CIN）的女性。
方法：我们报告了1371名HIV阳性女性和8050名HIV阴性女性的数据，年龄在17 - 65岁之间，这些女性是从南非开普敦的普通人群中招募的，没有宫颈癌筛查史，并参与了三项连续的研究。所有女性都进行了HIV检测。对宫颈样本进行高危型HPV DNA检测（杂交捕获2代），对阳性样本进行检测以确定具体基因型（线性杂交法）。CIN状态是根据阴道镜检查和活检确定的。
结果：总体而言，在所有年龄组中，HIV阳性女性的HPV患病率（52.4%）均高于HIV阴性女性（20.8%）。无论HIV状况如何，年龄在17 - 19岁的年轻女性HPV患病率最高。HIV阳性女性比HIV阴性女性更有可能患CIN 2级或3级病变。HPV 16、35和58是最常见的高危型HPV类型，按HIV状况划分，其类型分布没有重大差异。与HIV阴性女性相比，HPV 18在患有无病变或低级别病变的年龄较大（40 - 65岁）的HIV阳性女性中更为常见，但在患有CIN 2级或3级病变的年轻（17 - 29岁）女性中不太常见（p < 0.03）。在控制年龄和宫颈疾病状态的情况下，感染多种高危型HPV类型在HIV阳性女性中比在HIV阴性女性中更为常见。
结论：HIV阳性女性比HIV阴性女性更有可能感染高危型HPV；但是，在感染HPV的女性中，按HIV状况划分，HPV类型的分布是相似的。结合HPV基因分型和疫苗接种的筛查策略对于预防生活在撒哈拉以南非洲的HIV阳性和阴性女性的宫颈癌应该是有效的。
Objective: HIV-positive women are known to be at high-risk of human papillomavirus (HPV) infection and its associated cervical pathology. Here, we describe the prevalence and distribution of HPV genotypes among HIV-positive and -negative women in South Africa, with and without cervical intraepithelial neoplasia (CIN). Methods: We report data on 1,371 HIV-positive women and 8,050 HIV-negative women, aged 17–65 years, recruited into three sequential studies in Cape Town, South Africa, conducted among women who had no history of cervical cancer screening recruited from the general population. All women were tested for HIV. Cervical samples were tested for high-risk HPV DNA (Hybrid Capture 2) with positive samples tested to determine the specific genotype (Line Blot). CIN status was determined based on colposcopy and biopsy. Results: The HPV prevalence was higher among HIV-positive women (52.4%) than among HIV-negative women (20.8%) overall and in all age groups. Younger women, aged 17–19 years, had the highest HPV prevalence regardless of HIV status. HIV-positive women were more likely to have CIN 2 or 3 than HIV-negative women. HPV 16, 35, and 58 were the most common high-risk HPV types with no major differences in the type distribution by HIV status. HPV 18 was more common in older HIV-positive women (40–65 years) with no or low grade disease, but less common in younger women (17–29 years) with CIN 2 or 3 compared to HIV-negative counterparts (p < 0.03). Infections with multiple high-risk HPV types were more common in HIV-positive than HIV-negative women, controlling for age and cervical disease status. Conclusion: HIV-positive women were more likely to have high-risk HPV than HIV-negative women; but, among those with HPV, the distribution of HPV types was similar by HIV status. Screening strategies incorporating HPV genotyping and vaccination should be effective in preventing cervical cancer in both HIV-positive and -negative women living in sub-Saharan Africa.