Human Papillomavirus infection and cervical lesions in HIV infected women on antiretroviral treatment in Thailand
Human Papillomavirus infection and cervical lesions in HIV infected women on antiretroviral treatment in Thailand
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DOI：
10.1016/j.jinf.2017.02.007
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发表时间：
2017-05-01
影响因子：
28.2
通讯作者：
Le Coeur, Sophie
中科院分区：
文献类型：
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作者：
Delory, Tristan;Ngo-Giang-Huong, Nicole;Le Coeur, Sophie
目的：估计与人乳头瘤病毒 (HPV) 感染、HPV 基因型和细胞学/组织学高级 (HSIL+/CIN2+) 病变相关的患病率和因素。方法：我们在接受联合抗逆转录病毒治疗 (cART) 的 HIV 感染女性前瞻性队列中进行了一项横断面研究。收集宫颈标本进行细胞学检查和 HPV 基因分型 (Papillocheck (R))。任何患有高危 HPV (HR-HPV) 和/或潜在 HR-HPV (pHR-HPV) 和/或 ASC-US 或更高 (ASC-US+) 病变的女性均被转诊进行阴道镜检查。使用混合效应逻辑回归模型研究了与 HR-HPV 感染和 HSIL+/CIN2+ 病变相关的因素。 结果：829 名女性入组：中位年龄 40.4 岁，接受 cART 的中位时间为 6.9 年，中位 CD4 细胞计数 536 个细胞/mm3，788 名 (96%) 的 HIV 病毒载量< 50copies/mL。在 214 例 (26%) HPV 感染者中：159 例 (19%) 具有≥ 1 种 HR-HPV，其中 38 例 (5%) HPV52、22 例 (3%) HPV16、9 例 (1%) HPV18； 21 名 (3%) 感染 pHR-HPV，34 名 (4%) 感染低危 HPV，56 名 (26%) 感染多种基因型。年龄较小、CD4 细胞计数低和受教育程度低与 HR-HPV 感染独立相关。 72 名女性 (9%) 患有 ASC-US+ 病变，28 名女性 (3%) 患有 HSIL+/CIN2+ 病变。 HR-HPV感染与HSIL+/CIN2+病变独立相关。结论：HPV感染和宫颈病变的患病率较低。 HPV基因型分布支持在泰国使用九价疫苗。 (C) 2017 年英国感染协会。由爱思唯尔有限公司出版。保留所有权利。
Objectives: To estimate the prevalence and factors associated with Human Papillomavirus (HPV) infection, HPV genotypes and cytological/histological high-grade (HSIL+/ CIN2+) lesions.Methods: We conducted a cross-sectional study within a prospective cohort of HIV-infected women on combination antiretroviral therapy (cART). Cervical specimens were collected for cytology and HPV genotyping (Papillocheck (R)). Any women with High-Risk-HPV (HR-HPV), and/or potentially HR-HPV (pHR-HPV) and/or ASC-US or higher (ASC-US+) lesions were referred for colposcopy. Factors associated with HR-HPV infection and with HSIL+/CIN2+ lesions were investigated using mixed-effects logistic regression models.Results: 829 women were enrolled: median age 40.4 years, on cART for a median of 6.9 years, median CD4 cell-count 536 cells/mm3, and 788 (96%) with HIV-viral load< 50copies/mL. Of 214 (26%) infected with HPV: 159 (19%) had >= 1 HR-HPV, of whom 38 (5%) HPV52, 22 (3%) HPV16, 9 (1%) HPV18; 21 (3%) had pHR-HPV, 34 (4%) low risk-HPV infection, and 56 (26%) had multiple genotypes. Younger age, low CD4 cell-counts and low education were independently associated with HR-HPV infection. 72 women (9%) had ASC-US+ and 28 (3%) HSIL+/CIN2+ lesions. HR-HPV infection was independently associated with HSIL+/CIN2+ lesions.Conclusion: The prevalence of HPV infection and of cervical lesions was low. The HPV genotype distribution supports the use of 9-valent vaccine in Thailand. (C) 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.