INTRODUCTION Primary-prevention by prophylactic vaccination against HPV related cancers and HPV-based screening programs are based on HPV-type distribution in immunocompetent individuals. HIV-infected women are at high risk of invasive HPV-disease sustained by a broader range of HPV-types and have higher multi-type infection rates than immunocompetent hosts. METHODS This is a cross-sectional analysis of HR-HPV type distribution in 805 HIV+ women (HIW) compared with a control group of 1402 immunocompetent HIV- women (SPW) enrolled in the VALHIDATE study in order to define HPV type-specific distribution according to cytology. RESULTS HIW had a 3.8, 3.6, and 2.7 times higher risk of ASCUS, LSIL and HSIL than SPW respectively. HPV-DNA prevalence was 28.4% in HIW and 11.81% in SPW (p<0.0001). The prevalence of infection increased from normal cytology to HSIL both in HIW (from 21.45% to 90.91%) and SPW (from 9.54% to 75%). The OR for women with normal cytology of having a positive HPV DNA test result of was 2.6 times higher in HIW than in SPW. The cumulative prevalence of HPV-16/18 in HSIL is much lower in HIW (36.4±28.4) than SPW (62.5±33.5). CONCLUSIONS A higher prevalence of infection and broader HPV type distribution were observed in HIV+ women compared to the general population. More than 60% of HSIL lesions of HIW patients are caused by single or multi-type infections from non-HPV16/18 HPVs. The potential 9v-HPV vaccine coverage could be even higher than that expected for the general population given the wide panel of HPV-types observed in the HSIL of HIV+ women.

Cervical human papillomavirus genotypes in HIV-infected women : a cross-sectional analysis of the VALHIDATE study / G. Orlando, S. Bianchi, M.M. Fasolo, F. Mazza, E.R. Frati, G. Rizzardini, A. Matteelli, N. Zanchetta, A. Amendola, E. Tanzi. - In: JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE. - ISSN 2421-4248. - 58:4(2017 Dec), pp. E259-E265. [10.15167/2421-4248/jpmh2017.58.4.804]

Cervical human papillomavirus genotypes in HIV-infected women : a cross-sectional analysis of the VALHIDATE study

S. Bianchi
Secondo
;
E.R. Frati;A. Amendola
Penultimo
;
E. Tanzi
Ultimo
2017-12

Abstract

INTRODUCTION Primary-prevention by prophylactic vaccination against HPV related cancers and HPV-based screening programs are based on HPV-type distribution in immunocompetent individuals. HIV-infected women are at high risk of invasive HPV-disease sustained by a broader range of HPV-types and have higher multi-type infection rates than immunocompetent hosts. METHODS This is a cross-sectional analysis of HR-HPV type distribution in 805 HIV+ women (HIW) compared with a control group of 1402 immunocompetent HIV- women (SPW) enrolled in the VALHIDATE study in order to define HPV type-specific distribution according to cytology. RESULTS HIW had a 3.8, 3.6, and 2.7 times higher risk of ASCUS, LSIL and HSIL than SPW respectively. HPV-DNA prevalence was 28.4% in HIW and 11.81% in SPW (p<0.0001). The prevalence of infection increased from normal cytology to HSIL both in HIW (from 21.45% to 90.91%) and SPW (from 9.54% to 75%). The OR for women with normal cytology of having a positive HPV DNA test result of was 2.6 times higher in HIW than in SPW. The cumulative prevalence of HPV-16/18 in HSIL is much lower in HIW (36.4±28.4) than SPW (62.5±33.5). CONCLUSIONS A higher prevalence of infection and broader HPV type distribution were observed in HIV+ women compared to the general population. More than 60% of HSIL lesions of HIW patients are caused by single or multi-type infections from non-HPV16/18 HPVs. The potential 9v-HPV vaccine coverage could be even higher than that expected for the general population given the wide panel of HPV-types observed in the HSIL of HIV+ women.
HIV-infected women; HPV types; cervical lesions; molecular epidemiology
Settore MED/42 - Igiene Generale e Applicata
Settore MED/07 - Microbiologia e Microbiologia Clinica
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/566922
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