Human Papillomavirus Infection and Cytologic Abnormalities of the Anus and Cervix Among HIV-Infected Women in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (The SUN Study)
Human Papillomavirus Infection and Cytologic Abnormalities of the Anus and Cervix Among HIV-Infected Women in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (The SUN Study)
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DOI：
10.1097/olq.0b013e3181f70253
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发表时间：
2011-04-01
影响因子：
3.1
通讯作者：
Brooks, John T.
中科院分区：
文献类型：
--
作者：
Kojic, Erna Milunka;Cu-Uvin, Susan;Brooks, John T.
背景：人类乳头瘤病毒（HPV）感染的宫颈和相关的异常宫颈细胞学在hiv感染的妇女已经很好地描述。人们对感染艾滋病毒的妇女的肛门HPV感染知之甚少。方法：SUN研究是一项前瞻性队列研究，涉及700名hiv感染患者，其中包括167名女性。在基线时，患者完成一份行为问卷，并提供宫颈和肛门拭子样本，用于HPV检测、基因分型和细胞学检查。在这里，我们展示了SUN研究中167名女性的基线数据。结果：基线结果可用于120名妇女（中位年龄：38岁，57%非西班牙裔黑人，中位CD4细胞计数444.5细胞/毫米(3)），其中77%接受抗逆转录病毒治疗。肛门和宫颈的HPV患病率分别为90%和83% (P = 0.039)，高危型（HR）患病率分别为85%和70% （P = 0.001）。肛门和宫颈异常细胞学检出率差异无统计学意义，分别为38%和33% （P = 0.217）。尽管宫颈细胞学异常与肛门细胞学异常存在相关性（相对风险：1.7,P = 0.024），但其识别肛门细胞学异常女性的敏感性（52.5%）和阳性预测值阳性（45.6%）较差。肛交史与肛门HPV感染或肛门细胞学异常无关。结论：在这组hiv感染妇女中，肛门HPV感染比宫颈HPV感染更为普遍和多样化。肛门细胞学异常与宫颈细胞学异常一样普遍，尽管宫颈细胞学异常可以预测肛门细胞学异常，但结果并不高度一致。这些数据支持对感染艾滋病毒的妇女进行肛门细胞学筛查研究的必要性。
Background: Human papillomavirus (HPV) infection of the cervix and related abnormal cervical cytology in HIV-infected women has been well described. Little is known about anal HPV infection in HIV-infected women.Methods: The SUN Study is a prospective cohort study of 700 HIV-infected patients including 167 women. At baseline, patients completed a behavioral questionnaire and provided, among other samples, cervical and anal swabs for HPV detection and genotyping and for cytologic examination. Here, we present the available baseline data on the 167 women in the SUN study.Results: Baseline results were available for 120 women (median age: 38 years, 57% non-Hispanic black, median CD4 cell count 444.5 cells/mm(3)), of whom, 77% were taking antiretroviral therapy. The prevalences in the anus and cervix of any HPV were 90% and 83%, respectively (P = 0.039), and of high-risk (HR) types 85% and 70%, respectively, (P = 0.001). There was no significant difference in the prevalences of abnormal cytology between the anus and cervix: 38% and 33%, respectively (P = 0.217). Although the presence of abnormal cervical cytology was associated with the presence of abnormal anal cytology (relative risk: 1.7, P = 0.024), its sensitivity (52.5%) and positive predictive value positive (45.6%) for identifying women with abnormal anal cytology were poor. A history of anal sex was not associated with anal HPV infection or abnormal anal cytology.Conclusions: In this cohort of HIV-infected women, anal HPV infection was more prevalent and diverse than cervical HPV infection. Anal cytologic abnormalities were as prevalent as cervical cytologic abnormalities, and although abnormal cervical cytology was predictive of abnormal anal cytology, results were not highly concordant. These data support the need for studies of anal cytologic screening of HIV-infected women.