Human Papillomavirus Correlates With Histologic Anal High-Grade Squamous Intraepithelial Lesions in Hispanics With HIV.
Human Papillomavirus Correlates With Histologic Anal High-Grade Squamous Intraepithelial Lesions in Hispanics With HIV.
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DOI：
10.1097/lgt.0000000000000416
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发表时间：
2018-10
影响因子：
3.7
通讯作者：
Ortiz AP
中科院分区：
文献类型：
--
作者：
Medina-Laabes DT;Suarez-Perez EL;Guiot HM;Muñoz C;Colón-López V;Tirado-Gómez M;Ortiz AP
评估波多黎各HIV感染成人临床样本中高危型人乳头瘤病毒（HR-HPV）感染与活检证实的组织病理学肛门鳞状上皮内病变（锡尔斯）严重程度之间的关联程度。这项横断面研究分析了2015年6月至2017年12月期间访问专业肛门肿瘤诊所的成年患者（n=239）的病历数据;收集了社会人口统计学，行为风险因素，病史，临床数据和病理报告。肛门HR-HPV和肛门SIL严重程度之间的关联程度，调整潜在的混杂因素，使用多项logistic模型进行评估。78.7%的患者有肛门HR-HPV感染，43.9%有组织病理学低度SIL（LSIL），37.7%有组织病理学高度SIL（HSIL）。肛门HR-HPV感染的患病率在无肛门SIL的患者中为63.6%，在有LSIL的患者中为70.5%，在有HSIL的患者中为95.6%。在调整不同的预测因素后，肛门HR-HPV感染的患者比无肛门HR-HPV感染的患者更容易发生HSIL（比值比：11.0; 95%置信区间：3.2 - 37.2）;而LSIL没有显著增加（比值比：1.4; 95%置信区间：0.6 - 3.1）。这项研究表明，肛门HR-HPV感染和HSIL之间有很强的关联。同样，在HIV感染者中观察到肛门HR-HPV感染和肛门SIL的高患病率。我们的研究结果强调了筛查肛门HR-HPV感染和肛门SIL的重要性，并优化了HIV感染者的HPV疫苗接种策略。这项在感染HIV的西班牙裔成人中进行的基于临床的横断面研究显示，肛门HR-HPV感染与组织病理学肛门HSIL之间存在显著相关性。
To estimate the magnitude of association between anal infection with high-risk human papilloma virus (HR-HPV) types and severity of biopsy-confirmed histopathological anal squamous intraepithelial lesions (SILs) among a clinic-based sample of HIV-infected adults in Puerto Rico. This cross-sectional study analyzed data from medical records of adult patients who visited a specialized anal neoplasia clinic from June 2015 to December 2017 (n=239); sociodemographics, behavioral risk factors, medical history, clinical data and pathology reports were collected. The magnitude of association between anal HR-HPV and severity of anal SIL, adjusted for potential confounders, was assessed using a multinomial logistic model. A 78.7% of patients had anal HR-HPV infection, 43.9% had histopathological low-grade SIL (LSIL), and 37.7% had histopathological high-grade SIL (HSIL). The prevalence of anal HR-HPV infection was 63.6% among patients with no anal SIL, 70.5% for those with LSIL and 95.6% for those with HSIL. After adjusting for different predictors, patients with anal HR-HPV infection were more likely to have HSIL (odd ratio: 11.0; 95% confidence interval: 3.2 – 37.2) than those without anal HR-HPV infection; whereas no significant excess was observed for LSIL (odd ratio: 1.4; 95% confidence interval: 0.6 – 3.1). This study showed a strong association between anal HR-HPV infection and HSIL. Likewise, a high prevalence of anal HR-HPV infection and presence of anal SIL was observed among HIV-infected individuals. Our result highlights the importance of screening for anal HR-HPV infection and anal SIL, and to optimize strategies for HPV vaccination in HIV-infected individuals. This clinic-based cross-sectional study among HIV-infected Hispanic adults showed a strong significant association between anal HR-HPV infection and histopathological anal HSIL.