为了表征HSIL和ICC活检中的HPV基因型分布,WLWH,在欧洲,与艾滋病毒阴性的女性相比。
队列和嵌套病例对照研究。
我们通过对来自WLWH(n=170)的HSIL和ICC活检进行PCR来表征HPV基因型分布;将85例病例与85例HIV阴性匹配对照进行比较。估计了可能受到HPV疫苗保护的患者比例。
在WLWH(中位年龄36岁,HIV感染的中位持续时间为70,5个月,在cART下79%):最常检出的HPV是HPV16(30%),HPV35(16%),HPV58(14,7%),HPV31(13,5%),和HPV52(11,7%)。在WLWH中发现HPV16的频率较低,源自中部非洲(20,5%),而其他非洲区域(35,5%)(p=0.05)或世界区域(38,8%)(p=0.007)。多重与单一高危HPV感染与年龄较小(≤35岁)相关(比值比(OR)2,65(95%IC:1,3-5,2,p=0,002),淋巴细胞CD4计数<350个细胞/μL(OR2,7(95%IC:2-8,5;p=0,005),使用cART<18个月OR2,2(95%IC:1,1-4,5),p=0.04)或无法检测到的HIV病毒载量少于12个月的累积时间(OR4,2(95%IC:2-8.5,p=0,001)。在来自WLWH的样品中比在HIV阴性对照中更频繁地检测到HPV31、33和35(p<0.05)。9价疫苗将增加HPV保护,艾滋病毒阳性和阴性妇女(p<0.001)。
与HIV阴性相比,WLWH感染除16和18以外的高危HPV的频率更高。9价疫苗的使用可以预防多达85%的妇女的HSIL或ICC。将HPV35添加到HPV疫苗组中,可能会提高WLWH疫苗的有效性。
To characterize HPV genotype distribution in HSIL and ICC- biopsies, of WLWH, in Europe, as compared to HIV-negative women.
Cohort- and nested -case control study.
We characterized HPV genotype distribution by performing PCR on HSIL and ICC biopsies from WLWH (n = 170); 85 cases were compared to 85 HIV-negative matched controls. The proportion of patients that might be protected by HPV vaccines was estimated.
Among WLWH (median age 36 years-old, median duration of HIV infection 70,5 months, 79% under cART): the most frequently detected HPV were HPV16 (30%), HPV35 (16%), HPV58 (14,7%), HPV31 (13,5%), and HPV52 (11,7%). HPV16 was less frequently found in WLWH, originating from Central Africa (20,5%) compared to other African regions (35,5%) (p = 0,05) or world regions (38,8%) (p = 0,007). Multiple versus single high-risk HPV infections were associated with younger age (≤35 years)(odds ratio (OR) 2,65 (95%IC: 1,3-5,2,p = 0,002), lymphocyte CD4 count < 350 cells / µL (OR 2,7 (95%IC: 2-8,5; p = 0,005), use of cART for < 18 month OR 2,2 (95%IC: 1,1-4,5),p = 0,04) or a cumulative time with undetectable HIV viral load of less than 12 months (OR 4,2 (95%IC: 2-8.5,p = 0,001). HPV 31, 33 and 35 were more frequently detected in samples from WLWH than in HIV-negative controls (p < 0,05). The 9-valent vaccine would increase HPV protection, in HIV-positive and negative women (p < 0,001).
WLWH are more frequently infected with high-risk HPV other than 16 and 18 than HIV-negative ones. The use of 9-valent vaccine may prevent HSIL or ICC in up to 85% of the women. Adding HPV 35 to the HPV vaccine panel, might improve vaccine effectiveness in WLWH.