Prevalence, incidence and correlates of low risk HPV infection and anogenital warts in a cohort of women living with HIV in Burkina Faso and South Africa.
Prevalence, incidence and correlates of low risk HPV infection and anogenital warts in a cohort of women living with HIV in Burkina Faso and South Africa.
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DOI：
10.1371/journal.pone.0196018
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
HARP Study Group
中科院分区：
文献类型：
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作者：
Chikandiwa A;Kelly H;Sawadogo B;Ngou J;Pisa PT;Gibson L;Didelot MN;Meda N;Weiss HA;Segondy M;Mayaud P;Delany-Moretlwe S;HARP Study Group
报告布基纳法索（BF）和南非（SA）HIV感染妇女（WLHIV）中低风险人乳头瘤病毒感染（LR-HPV）和肛门生殖器疣（AGW）的患病率和发病率，并探讨与这些结果相关的HIV相关因素。我们招募了1238名25-50岁的WLHIV（BF = 615; SA = 623），并在招募后的三个时间点（6，12和16个月）对他们进行了随访。在妇科检查期间评估AGW的存在。通过Inno-LiPA®基因分型检测入组和第16个月随访访视的宫颈阴道拭子的HPV感染。Logistic回归用于评估流行感染或AGW的危险因素。考克斯回归用于评估事件AGW的风险因素。SA中的妇女比BF中的妇女更可能具有普遍的LR-HPV感染（BF：27.1% vs. SA：40.9%; p<0.001）和偶发的LR-HPV感染（BF：25.8% vs. SA：31.6%，p = 0.05）。两个国家持续性LR-HPV的患病率相似（BF：33.3% vs. SA：30.4%; p = 0.54），AGW的患病率和发生率也相似（患病率：BF：7.5% vs. SA：5.7%; p = 0.21;发生率：BF：2.47 vs. SA：2.33/100人-年; p = 0.41）。HPV 6与AGW事件相关（BF：校正的风险比（aHR）= 4.88; 95%CI：1.36-17.45; SA：aHR = 5.02; 95%CI：1.40-17.99）。流行LR-HPV（BF：校正比值比[aOR = 1.86]; 95%CI：1.01-3.41; SA：aOR = 1.75; 95%CI：0.88-3.48）;持续性LR-HPV（BF：aOR = 1.92; 95%CI：0.44-8.44; SA：aOR = 2.81; 95%CI：1.07-7.41）和普遍性AGW（BF：aOR = 1.53; 95%CI：0.61-3.87; SA：aOR = 4.11; 95%CI：1.20-14.10）均与低CD 4+计数（即500<200 vs. >个细胞/μL）相关。ART持续时间和HIV血浆病毒载量与任何LR-HPV感染或AGW结果无关。LR-HPV感染和AGW在撒哈拉以南非洲的WLHIV中很常见。型特异性HPV疫苗和免疫重建的有效ART可以减轻该人群的AGW负担。
To report the prevalence and incidence of low-risk human papillomavirus infection (LR-HPV) and anogenital warts (AGW) among women living with HIV (WLHIV) in Burkina Faso (BF) and South Africa (SA), and to explore HIV-related factors associated with these outcomes. We enrolled 1238 WLHIV (BF = 615; SA = 623) aged 25–50 years and followed them at three time points (6, 12 and 16 months) after enrolment. Presence of AGW was assessed during gynaecological examination. Cervico-vaginal swabs for enrolment and month 16 follow-up visits were tested for HPV infection by Inno-LiPA® genotyping. Logistic regression was used to assess risk factors for prevalent infection or AGW. Cox regression was used to assess risk factors for incident AGW. Women in SA were more likely than those in BF to have prevalent LR-HPV infection (BF: 27.1% vs. SA: 40.9%; p<0.001) and incident LR-HPV infection (BF: 25.8% vs. SA: 31.6%, p = 0.05). Prevalence of persistent LR-HPV was similar in the two countries (BF: 33.3% vs. SA: 30.4%; p = 0.54), as were prevalence and incidence of AGW (Prevalence: BF: 7.5% vs. SA: 5.7%; p = 0.21; Incidence: BF: 2.47 vs. SA: 2.33 per 100 person-years; p = 0.41). HPV6 was associated with incident AGW (BF: adjusted Hazard Ratio (aHR) = 4.88; 95%CI: 1.36–17.45; SA: aHR = 5.02; 95%CI: 1.40–17.99). Prevalent LR-HPV (BF: adjusted Odds Ratio [aOR = 1.86]; 95%CI: 1.01–3.41; SA: aOR = 1.75; 95%CI: 0.88–3.48); persistent LR-HPV (BF: aOR = 1.92; 95%CI: 0.44–8.44; SA: aOR = 2.81; 95%CI: 1.07–7.41) and prevalent AGW (BF: aOR = 1.53; 95%CI: 0.61–3.87; SA: aOR = 4.11; 95%CI: 1.20–14.10) were each associated with low CD4+ counts (i.e. <200 vs. >500 cells/μL). Duration of ART and HIV plasma viral load were not associated with any LR-HPV infection or AGW outcomes. LR-HPV infection and AGW are common in WLHIV in sub-Saharan Africa. Type-specific HPV vaccines and effective ART with immunological reconstitution could reduce the burden of AGW in this population.
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影响因子：
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作者：
Bursac, Zoran;Gauss, C Heath;Williams, David Keith;Hosmer, David W
通讯作者：
Hosmer, David W
影响因子：
3.6
作者：
Ghanem, Khalil G.;Datta, S. Deblina;Koutsky, Laura A.
通讯作者：
Koutsky, Laura A.
影响因子：
3.7
作者：
Low, Andrea J.;Clayton, Tim;Mayaud, Philippe
通讯作者：
Mayaud, Philippe
影响因子：
1.4
作者：
Jeynes, C.;Chung, M. C.;Challenor, R.
通讯作者：
Challenor, R.
DOI：
10.1093/cid/ciw354
发表时间：
2016-08-15
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Garland SM;Kjaer SK;Muñoz N;Block SL;Brown DR;DiNubile MJ;Lindsay BR;Kuter BJ;Perez G;Dominiak-Felden G;Saah AJ;Drury R;Das R;Velicer C
通讯作者：
Velicer C