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2.
Eur J Cancer Prev ; 27(1): 46-53, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-27359375

RESUMO

Although high-risk (HR) human papilloma virus (HPV) infection is the primary causative factor for cervical squamous intraepithelial lesions and invasive cervical cancer, the epidemiology of potentially HR (pHR) and low-risk HPV still remains to be elucidated in HIV-infected women. In addition, the synergistic potential of the multiplicity of HPV infections harboured renders it difficult to model the impact of vaccines. This cross-sectional analysis of HIV-infected women explores the epidemiology of abnormal cytology, thereby profiling and pairing pHR/HR HPV genotypes. This cross-sectional analysis reports the findings of 593 HIV-infected women, who underwent a cytological examination and HPV genotyping. A logistic regression model was fitted to adjust for age and coinfection with pHR/HR HPV genotypes. In the 143 women with abnormal cytology, a multiple pHR/HR HPV genotype prevalence of 64.1% [95% confidence interval (CI): 44.6-57.6%] was observed. A combined prevalence of HPV 16 and HPV 18 of 29.6% (95% CI: 22.2-37.8%) was found. HPV 6 and HPV 66 were found in two cases of low-grade squamous intraepithelial lesions as stand-alone genotypes and HPV 53 in a high-grade squamous intraepithelial lesion case. Pairing involving HPV 31 with HPV 16 and HPV 58 was found in high-grade squamous intraepithelial lesion cases. Significant associations were observed between abnormal cytology, multiple HPV, HPV 39 and HPV 53 [adjusted odds ratio (aOR): 2.02; P=0.01; 95% CI: 1.2-3.5; aOR: 3.8; P=0.01; 95% CI: 1.4-10.7; and aOR: 0.5; P=0.03; 95% CI: 0.2-0.9, respectively]. Coinfection with pHR/HR HPV genotypes HPV 39 and 53 was significantly associated with abnormal cytology. Research into the imputed role of HPV 31 in pairings, low-risk and pHR HPV genotypes in HIV-infected women is warranted.


Assuntos
Infecções por HIV/tratamento farmacológico , Terapia de Imunossupressão/efeitos adversos , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Lesões Intraepiteliais Escamosas Cervicais/epidemiologia , Adulto , Bélgica/epidemiologia , Estudos Transversais , Feminino , Genótipo , Infecções por HIV/imunologia , Infecções por HIV/virologia , Humanos , Teste de Papanicolaou , Papillomaviridae/genética , Papillomaviridae/imunologia , Infecções por Papillomavirus/imunologia , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/administração & dosagem , Lesões Intraepiteliais Escamosas Cervicais/imunologia , Lesões Intraepiteliais Escamosas Cervicais/prevenção & controle , Lesões Intraepiteliais Escamosas Cervicais/virologia , Esfregaço Vaginal
3.
Infect Agent Cancer ; 12: 2, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28070215

RESUMO

BACKGROUND: Whilst the imputed role of High Risk (HR) HPV infection in the development of cervical lesions and cancer has been established, the high number of HPV genotypes that Female Sex workers (FSW) harbour warrants that the synergistic effects of potential HR (pHR) and HR HPV genotypes be elucidated to assess the potential impact of prophylactic vaccines. This population in Kenya also harbours a number of other vaginal infections and STIs, including bacterial vaginosis (BV), trichomonas vaginalis (TV) and candida spp. The aims of this cross-sectional analysis in Kenya are to explore the epidemiology of abnormal cytology and the pairing of pHR/HPV genotypes in HIV-negative and HIV-infected FSW. METHODS: A cross-sectional study design of 616 FSW from Western Kenya aged between 18 and 61 years during 2009-2015 using a peer recruitment sampling strategy. RESULTS: Of the 599 FSW who underwent cytological examination, 87 had abnormal cytology (14.5%; 95% CI: 12.0-17.6%). A combined prevalence of HPV16 and 18 (29.6%; 95% CI: 22.2-37.8%) was observed in abnormal cytology. HPV 53 and 51 were the most observed pairing in FSW with abnormal cytology. Significant adjusted associations were found between abnormal cytology and TV (aOR: 30; 95% CI: 14.1-62.9), multiple HR HPV (aOR: 3.7; 95% CI: 1.9-7.3), HPV 51 (aOR 3.7; 95% CI 1.6-8.6) and HPV 52 (aOR 6.1; 95% CI: 2.8-13.3). CONCLUSION: HPV 51 and 52 were independently associated with abnormal cervical cytology in both HIV negative/positive FSW. The strong association between TV and cervical dysplasia and the high percentage of FSW harbouring more than one STI underscore the need for enhanced STI management within the framework of cervical cancer prevention.

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