Monday, October 5, 2015

Association of Cervical Precancer with Human Papillomavirus Types Other Than 16 among HIV Co-Infected Women

HIV seropositive women face high risk for infection with oncogenic types of human papillomaviruses (oncHPV), abnormal Pap tests and precancer, but cervical cancer risk is only modestly increased. HPV16 is highly oncogenic but only weakly associated with HIV-status and immunosuppression, suggesting HPV16 may have a greater innate ability to evade host immune surveillance than other oncHPV types which in turn should result in a greater relative increase in the prevalence of other oncHPV types among women with cervical precancer.

To assess whether the under-representation of HPV16 among HIV-seropositive relative to HIV-seronegative women remains among those with cervical precancers.

HIV seropositive and seronegative women in the Women's Interagency HIV Study were screened for cervical intraepithelial neoplasia grade 3 or worse (CIN3+). DNA from >40 HPV types was detected by PCR in cervicovaginal lavage specimens obtained at the visit at which CIN3+ was diagnosed.

HPV16 was detected in 13 (62%) of 21 HIV-seronegative women with CIN3+ but only 44 (29%) of 154 HIV-seropositive CIN3+ (P=0.01). The lower prevalence of HPV16 in CIN3+ among HIV seropositive women persisted after controlling for covariates (O.R. 0.25, 95% C.I. 0.08, 0.78). The prevalence of other members of the HPV16-related alpha-9 oncHPV clade as a group was similar in HIV-infected and uninfected women with CIN3+ (OR=1.02, 95% C.I. 0.53, 1.94). The prevalence of non-alpha-9 oncHPV types was increased in HIV seropositive vs seronegative women with CIN3+ (OR=3.9, 95% C.I. 1.3, 11.8).

The previously demonstrated increase in CIN3+ incidence among HIV seropositive women is associated with lower HPV16 and higher non-alpha-9 oncHPV prevalence. This is consistent with prior reports that HIV has a weak effect on infection by HPV16 relative to other oncHPV and supports use of nonavalent HPV vaccine in HIV seropositive women.

Via: http://goo.gl/KMVxYz  Purchase full article at: http://goo.gl/Gc6i01

  • 1Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO. 
  • 2Albert Einstein College of Medicine, Bronx, NY.
  • 3Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  • 4Departments of Pathology and Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, CA.
  • 5Maimonides Medical Center, Brooklyn, NY.
  • 6Georgetown University, Washington, DC.
  • 7Los Angeles County-University of Southern California Medical Center, Los Angeles, CA.
  • 8University of California, San Francisco, CA. 


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