Cervicovaginal human papillomavirus infection in human immunodeficiency virus-1 (HIV)-positive and high-risk HIV-negative women
Cervicovaginal human papillomavirus infection in human immunodeficiency virus-1 (HIV)-positive and high-risk HIV-negative women
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DOI：
10.1093/jnci/91.3.226
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发表时间：
1999-02-03
影响因子：
10.3
通讯作者：
Burk, R
中科院分区：
文献类型：
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作者：
Palefsky, JM;Minkoff, H;Burk, R
背景：人乳头瘤病毒（HPV）感染与人类免疫缺陷病毒-1 （HIV）感染妇女中常见的癌前宫颈鳞状上皮内病变有关，我们在参与妇女机构间HIV研究的HIV阳性和HIV阴性妇女中对HPV感染进行了大队列研究，以确定HIV阳性妇女宫颈阴道HPV感染的患病率和危险因素。hiv阳性（n = 1778）和hiv阴性（n = 500）妇女在入组时进行宫颈阴道灌洗标本中HPV DNA的检测。血液样本检测HIV抗体状态、cd4阳性T细胞水平和HIV RNA载量（拷贝数/mL），并进行详细的危险因素访谈。进行单因素和多因素分析。结果:与阴性妇女相比,HIV呈阳性的妇女的CD4(+)细胞计数低于200 /毫米(3)在HPV感染的风险最高,不管HIV RNA负载(优势比[或]= 10.13;95%可信区间[CI] = 7.32 - -14.04),其次是女性CD4 +计数大于200 / mm3和艾滋病毒RNA负载大于20 000拷贝/毫升(OR = 5.78; 95%可信区间-8.08 = 4.17)和女性的CD4(+)计数大于200 / mm3和艾滋病毒RNA负载小于20 000拷贝/毫升(OR = 3.12;95% CI = 2.36-4.12)，校正其他因素后。艾滋病毒阳性妇女的其他危险因素包括种族/民族背景（非裔美国人对白种人，OR = 1.64; 95% CI = 1.19-2.28）、当前吸烟（是对否；OR = 1.55; 95% CI = 1.20-1.99）和年龄较小（年龄为1.99岁）
Background: Human papillomavirus (HPV) infection is associated with precancerous cervical squamous intraepithelial lesions commonly seen among women infected with human immunodeficiency virus-1 (HIV), We characterized HPV infection in a large cohort of HIV-positive and HIV-negative women participating in the Women's Interagency HIV Study to determine the prevalence of and risk factors for cervicovaginal HPV infection in HIV-positive women, Methods: HIV-positive (n = 1778) and HIV-negative (n = 500) women were tested at enrollment for the presence of HPV DNA in a cervicovaginal lavage specimen. Blood samples were tested for HIV antibody status, level of CD4-positive T cells, and HIV RNA load (copies/mL), An interview detailing risk factors was conducted. Univariate and multivariate analyses were performed. Results: Compared with HIV-negative women, HIV-positive women with a CD4(+) cell count of less than 200/mm(3) were at the highest risk of HPV infection, regardless of HIV RNA load (odds ratio [OR] = 10.13; 95% confidence interval [CI] = 7.32-14.04), followed by women with a CD4+ count greater than 200/mm3 and an HIV RNA load greater than 20 000 copies/mL (OR = 5.78; 95% CI = 4.17-8.08) and women with a CD4(+) count greater than 200/mm3 and an HIV RNA load less than 20 000 copies/mL (OR = 3.12; 95% CI = 2.36-4.12), after adjustment for other factors. Other risk factors among HIV-positive women included racial/ethnic background (African-American versus Caucasian, OR = 1.64; 95% CI = 1.19-2.28), current smoking (yes versus no; OR = 1.55; 95% CI = 1.20-1.99), and younger age (age