Human papillomavirus types among women infected with HIV:: a meta-analysis
Human papillomavirus types among women infected with HIV:: a meta-analysis
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DOI：
10.1097/01.aids.0000253361.63578.14
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发表时间：
2006-11-28
期刊：
影响因子：
3.8
通讯作者：
Franceschi, Silvia
中科院分区：
文献类型：
--
作者：
Clifford, Gary M.;Goncalves, Maria Alice G.;Franceschi, Silvia
背景：艾滋病毒阳性妇女感染人乳头瘤病毒（HPV）的流行率高，感染的HPV类型比艾滋病毒阴性妇女范围更广。目前尚不清楚这些不同类型与高级别鳞状上皮内病变（HSIL）和癌症的关联程度。方法：对hiv阳性妇女中HPV类型特异性患病率进行荟萃分析，按地理区域和宫颈细胞学分层：正常、不确定意义的非典型鳞状细胞/低级别鳞状上皮内病变（ASCUS/LSIL）或HSIL。结果：在20项研究中，确定了5578名艾滋病毒阳性妇女，主要来自北美，但也来自非洲、亚洲、欧洲和南美/中美洲。在没有细胞学异常的3230人中，任何HPV的患病率为36.3%，多种HPV的患病率为11.9%。6种最常见的高危型HPV分别为16（4.5%）、58（3.6%）、18（3.1%）、52（2.8%）、31（2.0%）和33（2.0%）。在2053例ASCUS/LSIL和295例HSIL的hiv阳性妇女中，HPV16也是最常见的类型。与普通女性HSIL患者相比，HSIL患者感染HPV16的可能性明显降低（优势比为0.6；95%可信区间为0.4-0.7）。相比之下，hiv阳性的女性HSIL感染HPV型别为11、18、33、51、52、53、58和61的可能性更大，且存在多种HPV型别。结论：hiv阳性妇女感染HPV16的比例随着宫颈病变严重程度的增加而上升。然而，HPV16在hiv阳性的HSIL女性患者中的比例仍然偏低，与普通女性HSIL患者相比，其他HPV类型和多种类型的比例更高。(c) 2006年Lippincott Williams & Wilkins。
Background: HIV-positive women have a high prevalence of human papillomavirus (HPV) infection and are infected with a broader range of HPV types than HIV-negative women. It is not known to what extent these different types are associated with high-grade squamous intraepithelial lesions (HSIL) and cancer.Methods: Meta-analysis of HPV type-specific prevalence among HIV-positive women, stratified by geographical region and by cervical cytology: normal, atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL) or HSIL.Results: In 20 studies, 5578 HIV-positive women were identified, largely from North America but also Africa, Asia, Europe and South/Central America. For 3230 with no cytological abnormalities, prevalence was 36.3% for any HPV and 11.9% for multiple HPV types. The six most common high-risk HPV types were 16 (4.5%), 58 (3.6%), 18 (3.1%), 52 (2.8%), 31 (2.0%) and 33 (2.0%). HPV16 was also the most common type in 2053 HIV-positive women with ASCUS/LSIL and 295 with HSIL. Those with HSIL were significantly less likely to be infected with HPV16 (odds ratio, 0.6; 95% confidence interval, 0.4-0.7) than the general female population with HSIL. In contrast, HIV-positive women with HSIL were significantly more likely to be infected with HPV types 11, 18, 33, 51, 52, 53, 58 and 61, and with multiple HPV types.Conclusions: The proportion of HIV-positive women with HPV16 rose with increasing severity of cervical lesions. Nevertheless, HPV16 remained under-represented in HIV-positive women with HSIL, who showed a higher proportion of other HPV types and multiple types compared with the general female population with HSIL. (c) 2006 Lippincott Williams & Wilkins.