Prevalence and risk factors for anogenital HPV infection and neoplasia among women living with HIV in China

被引:8
作者
Duan, Rufei [1 ]
Zhang, Hongyun [2 ]
Wu, Aihui [3 ]
Li, Chongxi [4 ]
Li, Le [3 ]
Xu, Xiaoqian [1 ]
Qiao, Youlin [1 ]
Zhao, Fanghui [1 ]
Clifford, Gary [5 ]
机构
[1] Chinese Acad Med Sci & Peking Union Med Coll, Dept Canc Epidemiol, Natl Canc Ctr, Natl Clin Res Ctr Canc,Canc Hosp, Beijing, Peoples R China
[2] Kunming Med Univ, Dept Gynaecol & Obstet, Affiliated Hosp 1, Kunming, Yunnan, Peoples R China
[3] Third Peoples Hosp Kunming, Dept Obstet & Gynaecol, Kunming, Yunnan, Peoples R China
[4] Third Peoples Hosp Kunming, Dept Infect Dis, Kunming, Yunnan, Peoples R China
[5] Int Agcy Res Canc, Lyon, France
基金
中国国家自然科学基金; 国家重点研发计划;
关键词
HIV; cervical intraepithelial neoplasia; diagnostic screening programs; infection; health promotion; HUMAN-PAPILLOMAVIRUS INFECTION; CERVICAL INTRAEPITHELIAL NEOPLASIA; TAQMAN PCR; CANCER; IMMUNODEFICIENCY; HIV/AIDS; SAMPLES; LESIONS; BURDEN;
D O I
10.1136/sextrans-2021-055019
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives To explore the prevalence and risk factors of anogenital human papillomavirus (HPV) infection and neoplasia among women living with HIV (WLHIV) in China. Methods A cross-sectional survey was conducted from 2019 to 2020, 409 WLHIV aged 18 years and older were recruited from an HIV treatment clinic in Yunnan, China. Cervical and anal samples were collected for HPV testing of 15 HPV genotypes and cytological interpretation. Women positive for cervical HPV or cytological abnormalities were recalled for colposcopy examination and biopsy when necessary. Prevalence of anogenital HPV infection and neoplasia were compared by logistic regression. Results HPV prevalence was 34.2% (140/409) for cervical and 34.7% (142/409) for anal (high-risk HPV being 30.6% (125/409) and 30.3% (124/409), respectively). The most frequent genotypes were HPV-52, HPV-16 and HPV-58 in the cervix, HPV-52, HPV-53 and HPV-39 in the anus, with strong correlation between cervical and anal positivity, both overall and at a type-specific level. Cervical HPV was most associated with short duration of combination antiretroviral therapies (cART) (<= 2 vs >2 years, adjusted OR (aOR)=2.25, 95% CI: 1.22 to 4.12) and high initial HIV viral load (>= 1000 vs <1000 copies/mL, aOR=1.98, 95% CI: 1.10 to 3.58). Anal HPV was most associated with low nadir CD4 count (<200 vs >= 200 cells/mu L, aOR=1.80, 95% CI: 1.01 to 3.22) and low current CD4 count (<350 vs >= 500 cells/mu L, aOR=2.06, 95% CI: 1.00 to 4.36). CIN2+ prevalence was 4.6% and associated with low nadir CD4 count (aOR=4.63, 95% CI: 1.24 to 17.25). Conclusions Cervical and anal HPV were strongly correlated and, together with associated neoplasia, were highly prevalent among WLHIV in China. Early initiation of cART to avoid severe immunodeficiency should decrease anogenital HPV prevalence and related cancer burden among WLHIV. Incorporating anogenital cancer prevention services into HIV/AIDS care is warranted.
引用
收藏
页码:247 / 254
页数:8
相关论文
共 30 条
  • [1] [Anonymous], 1992, MMWR Recomm Rep, V41, P1
  • [2] Risk Factors for Anal Cancer in Persons Infected With HIV: A Nested Case-Control Study in the Swiss HIV Cohort Study
    Bertisch, Barbara
    Franceschi, Silvia
    Lise, Mauro
    Vernazza, Pietro
    Keiser, Olivia
    Schoeni-Affolter, Franziska
    Bouchardy, Christine
    Dehler, Silvia
    Levi, Fabio
    Jundt, Gernot
    Ess, Silvia
    Pawlita, Michael
    Kovari, Helen
    Wandeler, Gilles
    Calmy, Alexandra
    Cavassini, Matthias
    Stoeckle, Marcel
    Clifford, Gary
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 2013, 178 (06) : 877 - 884
  • [3] Optimizing Treatment for Adults with HIV/AIDS in China: Successes over Two Decades and Remaining Challenges
    Cao, Wei
    Hsieh, Evelyn
    Li, Taisheng
    [J]. CURRENT HIV/AIDS REPORTS, 2020, 17 (01) : 26 - 34
  • [4] China NHCotpsRo, 2019, DIAGN HIV AIDS HLTH
  • [5] Chinese Preventive Medicine Association Society of Women Health, 2017, FUID COMPR PREV CONT
  • [6] A meta-analysis of anal cancer incidence by risk group: Toward a unified anal cancer risk scale
    Clifford, Gary M.
    Georges, Damien
    Shiels, Meredith S.
    Engels, Eric A.
    Albuquerque, Andreia
    Poynten, Isobel Mary
    de Pokomandy, Alexandra
    Easson, Alexandra M.
    Stier, Elizabeth A.
    [J]. INTERNATIONAL JOURNAL OF CANCER, 2021, 148 (01) : 38 - 47
  • [7] Immunodeficiency and the risk of cervical intraepithelial neoplasia 2/3 and cervical cancer: A nested case-control study in the Swiss HIV cohort study
    Clifford, Gary M.
    Franceschi, Silvia
    Keiser, Olivia
    Schoeni-Affolter, Franziska
    Lise, Mauro
    Dehler, Silvia
    Levi, Fabio
    Mousavi, Mohsen
    Bouchardy, Christine
    Wolfensberger, Aline
    Darling, Katharine E.
    Staehelin, Cornelia
    Bertisch, Barbara
    Kuenzli, Esther
    Bernasconi, Enos
    Pawlita, Michael
    Egger, Matthias
    [J]. INTERNATIONAL JOURNAL OF CANCER, 2016, 138 (07) : 1732 - 1740
  • [8] Differentiation of herpes simplex virus types 1 and 2 in clinical samples by a real-time Taqman PCR assay
    Corey, L
    Huang, ML
    Selke, S
    Wald, A
    [J]. JOURNAL OF MEDICAL VIROLOGY, 2005, 76 (03) : 350 - 355
  • [9] Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study
    Franceschi, S.
    Lise, M.
    Clifford, G. M.
    Rickenbach, M.
    Levi, F.
    Maspoli, M.
    Bouchardy, C.
    Dehler, S.
    Jundt, G.
    Ess, S.
    Bordoni, A.
    Konzelmann, I.
    Frick, H.
    Dal Maso, L.
    Elzi, L.
    Furrer, H.
    Calmy, A.
    Cavassini, M.
    Ledergerber, B.
    Keiser, O.
    [J]. BRITISH JOURNAL OF CANCER, 2010, 103 (03) : 416 - 422
  • [10] Prevalence of Anal HPV and Anal Dysplasia in HIV-Infected Women From Johannesburg, South Africa
    Goeieman, Bridgette J.
    Firnhaber, Cynthia S.
    Jong, Eefje
    Michelow, Pam
    Kegorilwe, Patricia
    Swarts, Avril
    Williamson, Anna-Lise
    Allan, Bruce
    Smith, Jennifer S.
    Wilkin, Timothy J.
    [J]. JAIDS-JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES, 2017, 75 (03) : E59 - E64