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Fernández-Deaza G, Negrete-Tobar G, Caicedo M, Téllez N, Mello MB, Ghidinelli M, Nuche-Berenguer B, Murillo R. Cervical precancer and invasive cancer among women living with HIV in Latin America: A systematic review and meta-analysis. Int J STD AIDS 2024:9564624241276577. [PMID: 39222397 DOI: 10.1177/09564624241276577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Data on the occurrence of cervical precancer and cancer among women living with HIV (WLHIV) in Latin American countries (LAC) are scarce and highly heterogeneous. METHODS We conducted a systematic review summarizing data about the incidence/prevalence of invasive cervical cancer (CC) and high-grade precancerous lesions among WLHIV in LAC. Literature in PubMed and LILACS was searched. The primary outcome was invasive cancer incidence, and prevalence of high-grade lesions as key indicators for the WHO CC elimination strategy. Individual reports on invasive cancer incidence and prevalence of precancerous lesions were obtained, and a random effects meta-analysis was conducted for the latter. RESULTS In total, 34,343 WLHIV from four studies reporting CC incidence in seven LAC were included, and 6079 WLHIV from 17 studies reporting prevalence of precancerous lesions in three LAC were included. CC incidence ranged between 136.0 and 398.4 per 100,000 WLHIV (with or without antiretroviral therapy). The weighted prevalence of high-grade lesions was 4.1% (95%CI: 3.8%-6.0%) with a double peak at ages 20-24 and 35-39 years. Differences in prevalence of high-grade lesions were also observed by screening approach: co-testing (11.9%), colposcopy (6.0%), cytology (4.2%), and HPV tests (3.2%). CONCLUSIONS The high incidence of invasive cancer and prevalence of high-grade lesions underline challenges to reach the WHO's elimination goal of CC incidence below four per 100,000 among WLHIV. Moreover, the high prevalence of high-grade lesions at younger ages than in the general population is a call to accelerate the implementation of the new WHO screening recommendations in WLHIV.
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Affiliation(s)
| | | | - María Caicedo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Nicolás Téllez
- Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
| | | | | | | | - Raúl Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
- Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
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Abdi M, Tamiru A, Tilahun T, Tiruneh G, Fite MB. Factors associated with human papillomavirus infections among women living with HIV in public health facilities in Western Oromia, Ethiopia. BMC Womens Health 2024; 24:423. [PMID: 39054526 PMCID: PMC11270813 DOI: 10.1186/s12905-024-03249-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Human Papillomavirus infection (HPV) is among the most common sexually transmitted infections with the highest incidence and prevalence worldwide. HPV has been established as the main cause of cervical cancer and remains a public health problem globally. In Western Oromia, Ethiopia cervical screening remains a major issue because of limited resources, and shortage of HPV testing technology. As a result, the prevalence of HPV and associated factors remain unknown among HIV-positive women. This study aimed to assess the prevalence of HPV and associated factors among women living with HIV attending Antiretroviral Therapy (ART) services in public health facilities of East Wollega and West Showa Zones, Ethiopia, 2022. METHOD Using a cross-sectional study design, a total of 415 women ≥ 18 years old were enrolled using systematic random sampling from five public health facilities. Cervical specimens were collected by a trained nurse from April 01 2022, to May 30, 2022, and tested at Nekemte Public Health Research and Referral Molecular Biology, a certified/accredited laboratory for HPV-DNA Polymerase Chain Reaction by expertise using Abbott m2000rt-PCR assays. Finally, Epi data version 4.6 was used for data entry and SPSS version 24.0 were used for data cleaning and analysis, and frequencies and prevalence of HPV were computed. Variables were identified using the multivariable model and statistically significant associations of variables were determined based on the adjusted odds ratio (AOR) with its 95% CI and P-value < 0.05 to determine the strength of association. RESULT The prevalence of HPV was 30.4% [95% CI: 26.0, 34.9]. Of HPV-infected women, 11.9% were positive for HPV-16, 9.5% for HPV-18, and 65.9% were positive for other hr-HPV . The odds of HPV infection among women aged beyond 48 years are 2.85 times the odds of HPV among people who were aged 18-27(AOR = 2.85, 95% CI: 1.16, 5.58). The odds of HPV infection among women who had three or more sexual partners is 4.12 times the odds of HPV infection among women with a single sexual partner(AOR = 4.12, 95% CI: 2.34-8.62). The odds of HPV infection among women who didn't use condom during sexual intercourse are 4.73 times the odds of HPV among women who used condom during sexual intercourse. (AOR = 4.73, 95% CI: 1.98-9.33). The odds of HPV infection among women who had history of is 4.52 times the odds of HPV infection among women with no history of abortion. [AOR = 4.52, 95% CI: 2.04, 6.89] The odds of HPV infection among women with history of Sexually Transmitted Infection (STI) 3.62 times the odds of HPV among women with no history of STI (AOR = 3.62, 95%CI: 1.75, 5.83). The odd of HPV among women with abnormal vaginal discharge is 3.31 times the odds of the disease among women with normal vaginal discharge [AOR = 3.31, 95% CI: 2.87,7.35). CONCLUSION AND RECOMMENDATION The prevalence of HPV infection among HIV-infected women was high in the study area. Given the above-associated factors, we recommend that the stakeholders integrate HPV prevention strategies into HIV /AIDS services. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections, which may explain the high prevalence among HIV-infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV-infected people.
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Affiliation(s)
- Mulatu Abdi
- Nekemte public health research and referral laboratory, Oromia regional health bureau, Nekemte, Ethiopia
| | - Afework Tamiru
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Temesgen Tilahun
- School of medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Gemechu Tiruneh
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
- Department of Public, Sunshine College, Nekemte, Ethiopia.
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Tchouaket MCT, Ka’e AC, Semengue ENJ, Sosso SM, Simo RK, Yagai B, Nka AD, Chenwi CA, Abba A, Fainguem N, Perno CF, Colizzi V, Fokam J. Variability of High-Risk Human Papillomavirus and Associated Factors among Women in Sub-Saharan Africa: A Systematic Review and Meta-Analysis. Pathogens 2023; 12:1032. [PMID: 37623992 PMCID: PMC10458438 DOI: 10.3390/pathogens12081032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) carries the highest burden of high-risk human papillomavirus (HR-HPV) in the world, driven by, and together with, HIV infection. This systematic review aimed to identify HR-HPV genotypes and their associated factors among women in SSA. METHODS A systematic review and meta-analysis of studies conducted in SSA on HR-HPV was conducted. Standard electronic databases were searched. R software version 3.6.0 was used for meta-analysis, with p < 0.05 considered statistically significant. RESULTS We included 28 articles with a total of 22,652 participants. The overall pooled prevalence of HR-HPV genotypes was 55.13%, albeit high heterogeneity between studies. The overall pooled prevalence of HR-HPV genotypes in HIV-positive individuals was 75.51%, compared to 52.97% in HIV-negatives (OR = 4.68 (0.71-30.76)). HPV 16 (18%), 35 (10.12%), 52 (9.98%), 18 (9.7%) and 45 (6.82%) genotypes were the most prevalent. Twelve studies identified the most frequently reported risk factors associated with HR-HPV, with HIV infection (66.66%), multiple sexual partners (41.66%) and young age (41.66%) being the most reported risk factors. CONCLUSIONS The combined prevalence of HR-HPV genotypes among women in general and HIV-infected women in particular remains high in SSA. The presence of several genotypes not covered by the vaccine is remarkable and suggests the need for revision of current vaccination policies to prevent HR-HPV infections.
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Affiliation(s)
- Michel Carlos Tommo Tchouaket
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- School of Health Sciences, Catholic University of Central Africa, Yaoundé P.O. Box 1110, Cameroon
| | - Aude Christelle Ka’e
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- Faculty of Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Ezechiel Ngoufack Jagni Semengue
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- Faculty of Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Faculty of Sciences, Evangelical University of Bandjoun, Bandjoun P.O. Box 127, Cameroon;
| | - Samuel Martin Sosso
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
| | - Rachel Kamgaing Simo
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
| | - Bouba Yagai
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- Faculty of Sciences, Evangelical University of Bandjoun, Bandjoun P.O. Box 127, Cameroon;
| | - Alex Durand Nka
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- Faculty of Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Faculty of Sciences, Evangelical University of Bandjoun, Bandjoun P.O. Box 127, Cameroon;
| | - Collins Ambe Chenwi
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- Faculty of Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Aissatou Abba
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
| | - Nadine Fainguem
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- Faculty of Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Faculty of Sciences, Evangelical University of Bandjoun, Bandjoun P.O. Box 127, Cameroon;
| | | | - Vittorio Colizzi
- Faculty of Sciences, Evangelical University of Bandjoun, Bandjoun P.O. Box 127, Cameroon;
| | - Joseph Fokam
- Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management, Yaoundé P.O. Box 3077, Cameroon (S.M.S.); (R.K.S.); (B.Y.); (A.D.N.); (C.A.C.); (A.A.); (N.F.)
- School of Health Sciences, Catholic University of Central Africa, Yaoundé P.O. Box 1110, Cameroon
- Faculty of Sciences, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Faculty of Sciences, Evangelical University of Bandjoun, Bandjoun P.O. Box 127, Cameroon;
- Faculty of Health Sciences, University of Buea, Buéa P.O. Box 63, Cameroon
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Fantin C, Freitas JB, Teles HFM, Oliveira BAS, Brito DV. High prevalence of HPV 18 and multiple infections with oncogenic HPV genotypes in women at risk of cervical cancer examined in Manaus, Brazil. Braz J Med Biol Res 2023; 56:e12720. [PMID: 37255098 DOI: 10.1590/1414-431x2023e12720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 03/26/2023] [Indexed: 06/01/2023] Open
Abstract
Cervical cancer is a serious public health problem in Brazil, especially in Manaus (Amazonas), the city with the highest incidence rate of cervical cancer in the country. Persistent infection with oncogenic human papillomavirus (HPV) genotypes is the cause of disease development. The aim of this study was to investigate the prevalence of oncogenic genotypes in women at high risk for cervical precancer examined in two policlinics in Manaus. One hundred and two patients who underwent colposcopy took part in the research. The DNA samples obtained from the cervical epithelium were analyzed by PCR with type-specific primers for the detection of eight oncogenic genotypes, which were chosen based on previous studies. The presence of HPV virus was detected in all samples. The most prevalent oncogenic genotypes were 18 (47.1%) and 16 (45.1%). Interestingly, HPV 18 was considered uncommon in this region. In addition to these, genotypes 31 (19.6%), 58 (19.6%), 33 (18.6%), and 45 (15.7%) also had a relatively high frequency in this population. Fifty-six women (54.9%) had multiple infections with up to five oncogenic types. Also, the presence of genotypes other than 16 and 18 was observed in most samples (57.8%), which also deserves attention since they are not covered by currently available vaccines against HPV in Brazil. The high prevalence and multiple infections with several oncogenic HPV genotypes in association with precursor lesions for cervical cancer highlighted the need to improve strategies to prevent this disease in Amazonas.
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Affiliation(s)
- C Fantin
- Programa de Pós-graduação em Biotecnologia e Recursos Naturais da Amazônia, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil
- Laboratório de Genética Humana, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil
| | - J B Freitas
- Programa de Pós-graduação em Biotecnologia e Recursos Naturais da Amazônia, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil
| | - H F M Teles
- Departmento de Ginecologia e Obstetrícia, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil
| | - B A S Oliveira
- Policlínica João dos Santos Braga, Secretaria de Estado de Saúde do Amazonas, Manaus, AM, Brasil
| | - D V Brito
- Laboratório de Genética Humana, Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil
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Megersa T, Dango S, Kumsa K, Lemma K, Lencha B. Prevalence of high-risk human papillomavirus infections and associated factors among women living with HIV in Shashemene town public health facilities, Southern Ethiopia. BMC Womens Health 2023; 23:125. [PMID: 36959649 PMCID: PMC10036163 DOI: 10.1186/s12905-023-02279-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 03/14/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Every year, large number of women are suffering from cervical cancer. Particularly women living with HIV are at high-risk of being suffered with it. Early testing of high-risk human papillomavirus infection can significantly reduce the incidence of cervical cancer. However, lack of early and regular testing has been identified as one of the major problems among risky populations. METHODS Institutional-based cross-sectional study design was conducted among women living with HIV in Shashemene town public health facilities with a total sample size of 406 from February 1-March 30, 2022. Systematic random sampling technique was employed to select the study subjects. A structured questionnaire and checklist was used to collect data. The collected data were cleaned, coded, and entered into Epi-info version 7.2.5 and exported to statistical package for social science version 24 for analysis. Finally, bi-variable and multivariable logistic regression analyses were performed to identify determinants of high-risk human papillomavirus. Odds ratio with 95% confidence interval was used to test association between exposure and outcome under study and p-value < 0.05 was considered significant. RESULTS The prevalence of high-risk HPV infections among study participant was 173(35.2%) with 95% CI (30.5%-40.1%). Prevalence of high-risk HPV type 16, 18 and other high-risk HPV types were 62(15.3%), 23(5.7%) and 58(14.3%), respectively. Having history of sexually transmitted infections [AOR = 3.120; 95% CI (1.977-4.923)], Endline CD4 count < 200 cells/mm3 [AOR = 3.072; 95% CI(1.009-9.350)], Endline HIV viral-load ≥ 50 copies/ml [AOR = 3.446; 95% CI(1.368-8.683)] and more than one-lifetime sexual partner [AOR = 2.112; 95% CI(1.297-3.441)] were significantly associated with high-risk HPV infections. CONCLUSION More than one third of women living with HIV had high-risk HPV. Having history of STI, low CD4 count, high viral load and multiple sexual partners were associated with high risk HPV. HIV positive women with these risk factors should be given special consideration in clinical and public health intervention.
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Affiliation(s)
- Tariku Megersa
- Shashemene Comprehensive Specialized Hospital, Shashemene, Oromia Regional State, Ethiopia.
| | - Sisay Dango
- Department of Public Health, Madda Walabu University Shashemene Campus, Shashemene, Ethiopia
| | - Kebede Kumsa
- Department of Public Health, Madda Walabu University Shashemene Campus, Shashemene, Ethiopia
| | - Kebebew Lemma
- Shashemene Comprehensive Specialized Hospital, Shashemene, Oromia Regional State, Ethiopia
| | - Bikila Lencha
- Department of Public Health, Madda Walabu University Shashemene Campus, Shashemene, Ethiopia
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Prevalence and genotype distribution of human papillomavirus infection among HIV-infected men who have sex with men living in Lower Silesia, Poland. Postepy Dermatol Alergol 2022; 39:1128-1133. [PMID: 36686024 PMCID: PMC9837593 DOI: 10.5114/ada.2022.122607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 04/12/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and is associated with the risk of anogenital and oropharyngeal cancers. Men who have sex with men (MSM) are at a high risk of HPV infection. However, little up-to-date data are available regarding the prevalence of HIV and HPV co-infection in MSM in Poland. Aim To evaluate the prevalence, genotype distribution and risk factors for HPV infection among HIV-positive MSM living in Lower Silesia. Material and methods A total of 54 HIV-positive and 28 HIV-negative MSM participated in the study. The polymerase chain reaction was performed to detect HPV from oral and anal swabs. A self-applied written questionnaire was conducted to collect sociodemographic and behavioural data. Results The prevalence rates of oral and anal HPV infection were higher in HIV-infected MSM than in HIV-negative MSM. Statistical analysis showed that the prevalence of high oncogenic genotypes, HPV 16 and HPV 18, at the anal site was significantly higher in patients with lower CD4 cell counts, in addition, HPV 18 infection was significantly more frequent in patients with higher levels of HIV RNA. Moreover, HPV 33 and HPV 52 at the anal site were significantly more common in patients with lower nadir CD4. Conclusions This is the first report of HPV infection among Polish HIV-infected MSM. Our results show that HIV-related immunodeficiency is associated with a higher prevalence of high-risk HPV infections, therefore early detection of HIV infection and initiation of antiretroviral therapy might reduce the risk of HPV-related diseases.
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Caicedo-Martínez M, Fernández-Deaza G, Ordóñez-Reyes C, Olejua P, Nuche-Berenguer B, Mello MB, Murillo R. High-risk human papillomavirus infection among women living with HIV in Latin America and the Caribbean: A systematic review and meta-analysis. Int J STD AIDS 2021; 32:1278-1289. [PMID: 34488503 DOI: 10.1177/09564624211037498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We carried out a systematic review to summarize available data regarding prevalence of high-risk human papillomavirus (HR-HPV) among women living with HIV (WLHIV) in Latin America and the Caribbean (LAC). A literature search in PubMed and LILACS was conducted and supplemented with cross-referencing and grey literature. The primary outcome was prevalence of HR-HPV by age as a major determinant of HPV infection. Pooled prevalence and weighted averages were obtained. A random effects meta-analysis conducted for HPV- and HIV-associated factors. In total, 6157 women from 19 cross-sectional studies were included. Weighted prevalence of HR-HPV in WLHIV was 51.0% (95% CI 42.8-59.1, I2 = 97.4%) with a bimodal trend by age. No association between antiretroviral therapy and HR-HPV prevalence was observed, but low CD4 cell count was associated (PR 1.64, 95% CI 1.07-2.52). Although not significant, a higher HR-HPV prevalence was observed with Hybrid Capture 2 versus PCR. The high prevalence of HR-HPV among WLHIV in LAC underlines the need for improved cervical cancer prevention and early detection in this vulnerable population. Moreover, the high prevalence across age groups, and particularly in young women, deserves careful consideration for defining target populations of HPV-based screening and HPV immunization programs.
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Affiliation(s)
- María Caicedo-Martínez
- Centro Javeriano de Oncología, 173049Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Ginna Fernández-Deaza
- Centro Javeriano de Oncología, 173049Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Camila Ordóñez-Reyes
- Centro Javeriano de Oncología, 173049Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Peter Olejua
- Oficina de Investigaciones, 173049Hospital Universitario San Ignacio, Bogotá, Colombia
| | | | - Maeve B Mello
- 50514Pan American Health Organization, Washington DC, USA
| | - Raúl Murillo
- Centro Javeriano de Oncología, 173049Hospital Universitario San Ignacio, Bogotá, Colombia
- Facultad de Medicina, Pontifica Universidad Javeriana, Bogotá, Colombia
- Early Detection, Prevention & Infection Branch, International Agency for Research on Cancer, Lyon, France
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Castle PE, Einstein MH, Sahasrabuddhe VV. Cervical cancer prevention and control in women living with human immunodeficiency virus. CA Cancer J Clin 2021; 71:505-526. [PMID: 34499351 PMCID: PMC10054840 DOI: 10.3322/caac.21696] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 08/07/2021] [Accepted: 08/10/2021] [Indexed: 12/16/2022] Open
Abstract
Despite being highly preventable, cervical cancer is the fourth most common cancer and cause of cancer death in women globally. In low-income countries, cervical cancer is often the leading cause of cancer-related morbidity and mortality. Women living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome are at a particularly high risk of cervical cancer because of an impaired immune response to human papillomavirus, the obligate cause of virtually all cervical cancers. Globally, approximately 1 in 20 cervical cancers is attributable to HIV; in sub-Saharan Africa, approximately 1 in 5 cervical cancers is due to HIV. Here, the authors provide a critical appraisal of the evidence to date on the impact of HIV disease on cervical cancer risk, describe key methodologic issues, and frame the key outstanding research questions, especially as they apply to ongoing global efforts for prevention and control of cervical cancer. Expanded efforts to integrate HIV care with cervical cancer prevention and control, and vice versa, could assist the global effort to eliminate cervical cancer as a public health problem.
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Affiliation(s)
- Philip E. Castle
- Division of Cancer PreventionNational Cancer InstituteNational Institutes of HealthRockvilleMaryland
- Division of Cancer Epidemiology and GeneticsNational Cancer InstituteNational Institutes of HealthRockvilleMaryland
| | - Mark H. Einstein
- Department of Obstetrics, Gynecology, and Reproductive HealthRutgers New Jersey Medical SchoolNewarkNew Jersey
| | - Vikrant V. Sahasrabuddhe
- Division of Cancer PreventionNational Cancer InstituteNational Institutes of HealthRockvilleMaryland
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da Silva BEB, de Lemos LMD, de Aragão Batista MV, Lima CA, Martins-Filho PR, Santos VS. Prevalence of human papillomavirus infection in Brazilian women living with HIV: a systematic review and meta-analysis. Expert Rev Anti Infect Ther 2021; 20:611-620. [PMID: 34612128 DOI: 10.1080/14787210.2022.1990039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE We systematically investigated the prevalence of HPV, high-risk HPV and its genotypes in women living with human immunodeficiency virus (WLHIV) in Brazil. METHODS A systematic search was performed up to 15 December 2020. We included studies that used molecular methods for HPV detection in cervical samples and reported the prevalence of HPV in Brazilian WLHIV. The pooled prevalence of HPV, high-risk HPV (HR HPV) and HPV types and their 95% confidence interval (CI) were estimated. Subgroup analyses and meta-regression were conducted. RESULTS Thity-seven studies accounting for 8,436 WLHIV were included. The pooled HPV prevalence was 62% (95%CI 55-68%; I2 = 96.98%; P < 0.001). Prevalence of high-risk HPV was 40% (95%CI, 54-68%; I2 = 94.23%; P < 0.001). We found a wide variety of high-risk HPV genotypes. The high-risk HPV types most reported were HPV 16 (16%) and HPV 58 (6%). We found an increasing ratio of positivity from normal cervix to cancer. There were different factors associated with high-risk HPV, with low CD4+ count the most frequent. CONCLUSION The increase in the ratio of high-risk HPV positivity from normal cervix to carcinogenic lesions highlights the need to implement well-established testing for high-risk HPV in this population.
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Affiliation(s)
| | | | | | - Carlos Anselmo Lima
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil
| | - Paulo Ricardo Martins-Filho
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil.,Investigative Pathology Laboratory, Federal University of Sergipe, Aracaju, Brazil
| | - Victor Santana Santos
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil.,Centre for Epidemiology and Public Health, Federal University of Alagoas, Arapiraca, Brazil.,Graduate Program in Health Sciences, Federal University of Alagoas, Maceió, Brazil
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Predictors of Pap Smear Screening Behavior Among Rural Women in Tabriz, Iran: An Application of Health Belief Model. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2019. [DOI: 10.5812/ijcm.87246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
PURPOSE OF REVIEW Adults living with HIV have an increased risk of malignancy yet there is little data for adolescents and young adults. We reviewed recently published cancer epidemiology, treatment, and outcome data for adolescents and young adults living with HIV (AYALHIV) aged 10 to less than 25 years between 2016 and 2017. RECENT FINDINGS AYALHIV are at increased risk of developing cancer compared to their uninfected peers. Kaposi sarcoma and non-Hodgkin lymphoma occur most frequently with variation by geographical region. Increased cancer risk is associated with HIV-related immunosuppression and coinfection with oncogenic viruses. Published data, particularly on posttreatment outcomes, remain limited and analyses are hampered by lack of data disaggregation by age and route of HIV transmission. SUMMARY Although data are sparse, the increased cancer risk for AYALHIV is the cause for concern and must be modified by improving global access and uptake of antiretroviral therapy, human papilloma virus (HPV) and hepatitis B virus (HBV) vaccination, screening for hepatitis B and C infection, and optimized cancer screening programs. Education aimed at reducing traditional modifiable cancer risk factors should be embedded within multidisciplinary services for AYALHIV.
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dos Santos LM, Vieira MRMDS, Oliveira JFG, Trindade JQ, Brasiliense DM, Ferrari SF, Tsutsumi MY, Fuzii HT, Sousa Junior EC, Ishikawa EAY, Ishak R, de Sousa MS. High prevalence of sexual Chlamydia trachomatis infection in young women from Marajó Island, in the Brazilian Amazon. PLoS One 2018; 13:e0207853. [PMID: 30496244 PMCID: PMC6264820 DOI: 10.1371/journal.pone.0207853] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 11/07/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection (STI) in the world. Approximately 80% of infected women are asymptomatic, although this infection can lead to serious complications in the female reproductive tract. Few data on Chlamydia infection are available in rural Amazonian communities. OBJECTIVES To evaluate the prevalence of sexual C. trachomatis infection in women from Marajó Archipelago communities in the Amazon region of Brazil and to identify associated factors and genotypes. METHODS We utilized amplification of the ompA gene by nested PCR. Positive samples were genotyped by sequencing. Study participants completed a questionnaire on social, epidemiological, and reproductive health variables. A Poisson regression was used to evaluate the degree of association of these variables with the infection. RESULTS The sexual infection by C. trachomatis was observed in 4% (16/393) of the subjects, and was more often found in women aged ≤25 (14.3%; 95% CI = 2.83-35.47; p <0.001), and in women with a household income of less than one Brazilian monthly minimum wage (5.2%; 95% CI = 1.33-11.37; p = 0.014). The ompA gene was sequenced in 13 samples, revealing F genotypes (38.4%, n = 5), D (23%, n = 3), E (15.3%, n = 2), Ia (7.6%, N = 1), J (7.6%, n = 1) and B (7.6%, n = 1). CONCLUSIONS We recorded a high prevalence of sexual infection by C. trachomatis in young and poor women from the interior of the Brazilian Amazon. This high prevalence and the frequencies of the main genotypes were similar to those found in major Brazilian urban centers. Our results reinforce the importance of the screening of this neglected infection, and the prevention of later sequelae in young women from rural and urban areas of Brazil.
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Affiliation(s)
- Leonardo Miranda dos Santos
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
- Programa de Pós-graduação em Doenças Tropicais, Universidade Federal do Pará, Belém, Pará, Brasil
| | - Maria Renata Mendonça dos Santos Vieira
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
- Programa de Pós-graduação em Análises Clínicas, Universidade Federal do Pará, Belém, Pará, Brasil
| | | | - Josinaide Quaresma Trindade
- Laboratório de Citopatologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brasi
| | | | | | - Mihoko Yamamoto Tsutsumi
- Programa de Pós-graduação em Análises Clínicas, Universidade Federal do Pará, Belém, Pará, Brasil
- Laboratório de Citopatologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brasi
| | - Hellen Thais Fuzii
- Laboratório de Imunopatologia, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
| | | | - Edna Aoba Yassui Ishikawa
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
| | - Ricardo Ishak
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brasil
| | - Maísa Silva de Sousa
- Laboratório de Biologia Molecular e Celular, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brasil
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Rodrigues LLS, Morgado MG, Sahasrabuddhe VV, De Paula VS, Oliveira NS, Chavez-Juan E, Da Silva DM, Kast WM, Nicol AF, Pilotto JH. Cervico-vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: High acceptability, hrHPV diversity and risk factors. Gynecol Oncol 2018; 151:102-110. [PMID: 30087059 PMCID: PMC6151287 DOI: 10.1016/j.ygyno.2018.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/23/2018] [Accepted: 08/01/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE We evaluated acceptability of cervico-vaginal self-collection (CVSC) and prevalence of human papillomavirus (HPV) in Human immunodeficiency virus (HIV)-infected and HIV-uninfected women living in the Tapajós region, Amazon, Brazil. METHODS Cross-sectional study recruited 153 non-indigenous women (HIV-uninfected, n = 112 and HIV-infected, n = 41) who voluntarily sought assistance in health services. Peripheral blood for HIV screening and cervical scraping (CS) for HPV detection were collected. Women who accepted to perform CVSC received instructions and individual collection kits. Risk factors for high-risk HPV genotypes (hrHPV) were identified by uni- and multivariate analyses. RESULTS The overall acceptability of CVSC was 87%. Only HIV-infected women had cytological abnormalities (12.2%). Prevalence of any HPV and hrHPV infection was 42.9% and 47.9% for HIV-uninfected and 97.6% and 77.5% for HIV-infected women, respectively. There was significant agreement in the detection of HPV (88%, 0.76, 95% confidence interval [CI], 0.65-0.87) and hrHPV (79.7%, 0.56, 95% CI, 0.41-0.71) between self-collected and clinician-collected samples. The most prevalent hrHPV types were HPV16 and HPV18 in HIV-uninfected and HPV16, HPV51 and HPV59 in HIV-infected women. HIV-infected women with hrHPV infection had multiple hrHPV infections (p = 0.005) and lower CD4 count (p = 0.018). Risk factors for hrHPV infection included being HIV-infected and having five or more sexual partners. CONCLUSIONS CVSC had high acceptability and high prevalence of hrHPV types in women living in the Tapajós region, Amazon, Brazil.
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Affiliation(s)
- Luana L S Rodrigues
- Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro, Brazil; Instituto de Saúde Coletiva, Universidade Federal do Oeste do Pará, Santarém, Pará, Brazil.
| | - Mariza G Morgado
- Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro, Brazil.
| | | | | | - Nathália S Oliveira
- Programa de Pós-Graduação em Patologia, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Elena Chavez-Juan
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Diane M Da Silva
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - W Martin Kast
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Department of Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA, USA
| | - Alcina F Nicol
- Instituto Nacional de Infectologia Evandro Chagas, INI-FIOCRUZ, Rio de Janeiro, Brazil; Laboratório Interdisciplinar de Pesquisas Médicas, IOC-FIOCRUZ, Rio de Janeiro, Brazil
| | - José H Pilotto
- Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro, Brazil
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Teixeira MF, Sabidó M, Leturiondo AL, de Oliveira Ferreira C, Torres KL, Benzaken AS. High risk human papillomavirus prevalence and genotype distribution among women infected with HIV in Manaus, Amazonas. Virol J 2018; 15:36. [PMID: 29454382 PMCID: PMC5816532 DOI: 10.1186/s12985-018-0942-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 02/01/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Human immunodeficiency virus (HIV)-positive women have a high prevalence of human papillomavirus (HPV), and are infected with a broader range of HPV types than HIV-negative women. We aimed to determine the prevalence of cervical cytologic abnormalities, high-risk (HR)-HPV prevalence, type distribution according to the severity of cervical lesions and CD4 cell count and identify factors associated with HR-HPV infection among women living with HIV in Manaus, Amazonas. METHODS We enrolled 325 women living with HIV that attended an infectious diseases referral hospital. Each woman underwent a gynecological exam, cervical cytology, HR-HPV detection by Polymerase chain Reaction (PCR) using the BD Onclarity™ HPV Assay, colposcopy and biopsy, when necessary. We assessed the associations between potential risk factors and HR-HPV infection. RESULTS Overall, 299 (92.0%) women had a PCR result. The prevalence of HR-HPV- infection was 31.1%. The most prevalent HR-HPV types were: 56/59/66 (32.2%), 35/39/68 (28.0%), 52 (21.5%), 16 (19.4%), and 45 (12.9%). Among the women with HR-HPV infection (n = 93), 43.0% had multiple infections. Women with HPV infection showed higher prevalence of cervical abnormalities than that HPV-negative (LSIL: 22.6% vs. 1.5%; HSIL: 10.8% vs. 0.0%). The prevalence of HR-HPV among women with cytological abnormalities was 87.5% for LSIL and 100.0% for HSIL. Women with CD4 < 200 cell/mm3 showed the highest HR-HPV prevalence (59.3%) although this trend was not statistically significant (p-value = 0.62). The mean CD4 cell count decreased with increasing severity of cervical lesions (p-value = 0.001). The multivariable analysis showed that increasing age was associated with a decreased risk of HR-HPV infection with an adjusted prevalence odds ratio of 0.9 (95.0% CI: 0.9-1.0, p-value: 0.03) for each additional year. The only factor statistically significant associated with HR-HPV infection was CD4 cell count. CONCLUSIONS HR-HPV and abnormal cytology prevalence are high among women in the Amazonas. The low CD4 cell count was an important determinant of HPV infection and abnormal cytological findings. HPV quadrivalent vaccination used in Brazil might not offer protection for an important fraction of HPV-related disease burden in women living with HIV. This is partly explained by the high presence of non targeted vaccine HR-HPVs, such as the HPV genotype groups 56/59/66, 35/39/68 and individually HPV-52 and HPV-45, some of which contribute to high-grade lesion.
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Affiliation(s)
- Monique Figueiredo Teixeira
- Universidade Federal do Amazonas (UFAM), 6200, Coroado I, General Rodrigo Octávio Ave, Manaus, Amazon, 69080-900, Brazil.
| | - Meritxell Sabidó
- TransLab. Departament de Ciències Mèdiques, Facultat de Medicina, Girona, Catalunya, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Kátia Luz Torres
- Fundação Centro de Controle de Oncologia do Amazonas (FCecon), Manaus, Amazonas, Brazil
| | - Adele Schwartz Benzaken
- Fundação Alfredo da Matta (FUAM), Manaus, Amazonas, Brazil.,Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.,Departamento de IST, Aids, e Hepatites Virais, Ministério da Saúde, Brasília, DF, Brazil
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Travassos AG, Netto E, Xavier-Souza E, Nóbrega I, Adami K, Timbó M, Abbehusen K, Fernandes S, Duran C, Haguihara T, Ferreira F, Brites C. Predictors of HPV incidence and clearance in a cohort of Brazilian HIV-infected women. PLoS One 2017; 12:e0185423. [PMID: 28981551 PMCID: PMC5628817 DOI: 10.1371/journal.pone.0185423] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/12/2017] [Indexed: 12/13/2022] Open
Abstract
Persistent infection with high-risk human papillomavirus (HR-HPV) is necessary for the development of precursor lesions and cervical cancer. HPV infection among women living with HIV/AIDS (WLHA) occurs more frequently, presents a higher rate of persistent infections and an earlier progression to cancer. We aimed to evaluate HR-HPV prevalence, incidence and clearance, and its association with HIV viral suppression, immunological response and other risk factors among WLHA followed at an STD/HIV reference center. This was a cohort study conducted at a reference center for STD/AIDS in Northeastern Brazil from September 2013 to September 2015. Follow-up visits were conducted at 6 and 12 months after enrolment, where socio-epidemiological data were obtained. Cervical samples were collected for conventional cytology and HPV DNA research (PCR COBAS® Roche) in addition to blood samples for CD4+ T lymphocyte count and HIV viral load. We prospectively evaluated 333 women. HR-HPV DNA prevalence was 33.3% at baseline. HPV-16 was present in 5.1%, HPV-18 in 3.9% and 29.4% WLHA had other HR-HPV (31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66 and 68). The HR-HPV incidence during the follow-up was 10.8%, at the 6-month visit was 7.7% and at the 12-month visit was 3.7%. Variables associated with HR-HPV incidence were: nulliparity, combined oral contraceptive use and detectable HIV viral load. The HR-HPV clearance rate was 41.7% and was associated with age >30 years and lymphocyte T CD4 count >500 cells/mm3 at enrolment. These findings contribute to the knowledge about a group of women that need more careful HPV screening and describe the association between an efficient immunological response and HIV viral suppression with lower incidence and increased clearance of HR-HPV.
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Affiliation(s)
- Ana Gabriela Travassos
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
- Colegiado de Medicina, Departamento de Ciências da Vida, Universidade Estadual da Bahia, Salvador, Bahia, Brazil
| | - Eduardo Netto
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | | | - Isabella Nóbrega
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Karina Adami
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Maiara Timbó
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Karen Abbehusen
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Sheyla Fernandes
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Camila Duran
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil
| | - Tatiana Haguihara
- Centro Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), Secretaria de Saúde do Estado da Bahia, Salvador, Bahia, Brazil
| | - Fábio Ferreira
- Laboratório Central de Saúde Pública Prof. Gonçalo Moniz, Salvador, Bahia, Brazil
| | - Carlos Brites
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia, Brazil
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Tartaglia E, Falasca K, Vecchiet J, Sabusco GP, Picciano G, Di Marco R, Ucciferri C. Prevalence of HPV infection among HIV-positive and HIV-negative women in Central/Eastern Italy: Strategies of prevention. Oncol Lett 2017; 14:7629-7635. [PMID: 29344211 DOI: 10.3892/ol.2017.7140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/08/2017] [Indexed: 11/06/2022] Open
Abstract
The present cross-sectional-study aimed to determine the prevalence of human papillomavirus (HPV)-genotypes among human immunodeficiency virus (HIV)-positive and -negative women in Central/Eastern Italy, and to identify the optimal strategies for effective HPV-prevention in each group. A representative sample of HIV-negative (150/200) and -positive (50/200) women, who underwent cervico-vaginal-swabbing. Swabs were analysed for a cytological screening and for a HPV-DNA-genotyping-test. A total of 66/200 swabs resulted HPV-positive. The overall HPV-prevalence was 33% with a higher prevalence in the HIV-positive-group (48%) compared with the HIV-negative-group (28%). The most frequent genotypes were: 16, 31, 52, 58, 66, 73 and 89. Furthermore, the prevalence of specific genotypes was different in each group. The results of the present study indicate that HIV infection appears to be an independent risk factor for HPV-infection. In addition, HPV-infection is more common and more likely to persist in HIV-positive compared with in HIV-negative women. The optimal way to counteract HPV infection is through primary prevention. The stage of immunity (cluster of differentiation 4-level) at the time of the HPV-screening is one of the most important parameters for detection of susceptibility to HPV-infection and to evaluate the response to the HPV-vaccine in HIV-positive women. It may be used to determine the sub-group of HIV-positive women that are more prone to HPV-infections or that exhibit a partial response to the HPV-vaccine. At present, a novel type of vaccine with 9-genotypes is available and in the near future, it may serve an essential role in the prevention of HPV infections.
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Affiliation(s)
- Edoardo Tartaglia
- Department of Medicine and Health Sciences 'Vincenzo Tiberio', University of Molise, I-86100 Campobasso, Italy
| | - Katia Falasca
- Department of Medicine and Science of Aging-Clinic of Infectious Diseases, University 'G.' d'Annunzio Chieti-Pescara, I-66100 Chieti, Italy
| | - Jacopo Vecchiet
- Department of Medicine and Science of Aging-Clinic of Infectious Diseases, University 'G.' d'Annunzio Chieti-Pescara, I-66100 Chieti, Italy
| | - Giovanna Paola Sabusco
- Department of Medicine and Health Sciences 'Vincenzo Tiberio', University of Molise, I-86100 Campobasso, Italy
| | - Giovanna Picciano
- Department of Gynecology and Obstetrics, Cardarelli Hospital, I-86100 Campobasso, Italy
| | - Roberto Di Marco
- Department of Medicine and Health Sciences 'Vincenzo Tiberio', University of Molise, I-86100 Campobasso, Italy
| | - Claudio Ucciferri
- Department of Medicine and Health Sciences 'Vincenzo Tiberio', University of Molise, I-86100 Campobasso, Italy
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Miranda AE, Silveira MF, Travassos AG, Tenório T, Val ICC, Lannoy L, Mattos Junior HS, Carvalho NS. High-risk papillomavirus infection among women living with human Immunodeficiency virus: Brazilian multicentric study. J Med Virol 2017; 89:2217-2223. [PMID: 28771777 DOI: 10.1002/jmv.24906] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/02/2017] [Indexed: 12/20/2022]
Abstract
Cervical cancer is an important health issue in Latin America. Although HPV infections can have spontaneous clearance, persistence of high-risk (HR) HPV is a risk factor for cervical cancer among women and it is even higher in HIV-infected women. To determine the prevalence of HR-HPV and risk factors among HIV-infected women attending reference services for HIV/AIDS in different regions of Brazil. Cross-sectional study conducted among HIV-infected women attended at referral care centers for HIV/AIDS in nine states of Brazil. Women from 18 to 49 years that accept to participate and were not pregnant at the time of the approach were recruited for the study. The HPV screening was realized using qPCR in closed system, in vitro Diagnostic, COBAS® -HPV Roche. The cytology results were available by the Bethesda System. A total of 802(89.1%) from the selected women agreed to participate in the study. Median age was 39(Inter quartile range [IQR34-46]) years and median education was 9(IQR6-11) years. General prevalence of HR-HPV was 28.4%(228/802). HPV-16 prevalence rate was 8.1%(65/802), HPV-18 was 3.7%(30/802) and other types of HR-HPV were 23.6% (189/802). Risk factors for HR-HPV infection in the multivariate logistic regression analysis were: age ranging from 18 to 34 years (OR = 1.43[95%CI:1.18-1.75]), illicit drugs use (OR = 1.61[95%CI:1.10-2.42]) and abnormal cervical cytology (OR = 1.56[95%CI:1.34-1.81]). Results showed a prevalence rate of 28.4% of HR-HPV infection in women living with HIV in Brazil. These infections were significantly associated with having less than 35 years old, illicit drug use and abnormal cervical cytology.
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Ortiz AP, Tamayo V, Scorsone A, Soto-Salgado M, Febo I, Piovanetti P, Venegas-Ríos HL, Yamamura Y, Zorrilla C. Prevalence and correlates of cervical HPV infection in a clinic-based sample of HIV-positive Hispanic women. PAPILLOMAVIRUS RESEARCH 2017; 4:39-44. [PMID: 29179868 PMCID: PMC5791754 DOI: 10.1016/j.pvr.2017.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/30/2017] [Accepted: 06/08/2017] [Indexed: 11/04/2022]
Abstract
Objectives Puerto Rico (PR), is the fifth highest jurisdiction of the United States of America (US) with respect to HIV prevalence and the leading in cervical cancer incidence. This cross-sectional study describes the prevalence and correlates of cervical HPV infection among a clinic-based sample of 302 women living with HIV/AIDS in PR. Methods Data collection included questionnaires, blood and cervical samples. Multivariable logistic regression models were used to estimate the magnitude of association (adjusted Prevalence odds ratio [aPOR]) between HPV cervical infection and other covariates. Results Mean age of participants was 40.3 years (± 10.3 SD). The prevalence of HPV infection was 50.3%; 41.1% for low-risk types and 29.5% for high-risk types. Having ≥ 10 lifetime sexual partners (aPOR = 2.10, 95% CI:1.02–4.29), an abnormal Pap (aPOR = 3.58, 95% CI:1.93–6.62), active genital warts (aPOR = 3.45, 95% CI:1.60–7.42), and CD4 counts ≤ 200 (aPOR = 4.24, 95% CI: 1.67–10.78) were positively associated with any cervical HPV infection. Similar results were observed for HR HPV infection. Conclusions A high burden of HPV co-infection exists among women living with HIV/AIDS in this population. Given the high incidence of HIV in PR and the higher risk of cervical cancer among women living with HIV/AIDS, HPV vaccination should be promoted in this population.
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Affiliation(s)
- A P Ortiz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, United States; Cancer Control and Population Sciences Program, University of Puerto Rico Comprehensive Cancer Center, San Juan, PR, United States.
| | - V Tamayo
- Maternal-Infant Studies Center (CEMI), Department of OB-GYN, University of Puerto Rico School of Medicine, San Juan, PR, United States
| | - A Scorsone
- Maternal-Infant Studies Center (CEMI), Department of OB-GYN, University of Puerto Rico School of Medicine, San Juan, PR, United States
| | - M Soto-Salgado
- Doctoral Program in Public Health with specialty in Social Determinants of Health, Department of Social Sciences, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, PR, United States
| | - I Febo
- Maternal-Infant Studies Center (CEMI), Department of OB-GYN, University of Puerto Rico School of Medicine, San Juan, PR, United States
| | - P Piovanetti
- Maternal-Infant Studies Center (CEMI), Department of OB-GYN, University of Puerto Rico School of Medicine, San Juan, PR, United States
| | - H L Venegas-Ríos
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, Medical Sciences Campus, San Juan, PR, United States
| | - Y Yamamura
- Aids Research Laboratory, Ponce Health Sciences University, Ponce, PR, United States
| | - C Zorrilla
- Maternal-Infant Studies Center (CEMI), Department of OB-GYN, University of Puerto Rico School of Medicine, San Juan, PR, United States; Department of OB-GYN, University of Puerto Rico School of Medicine, San Juan, PR, United States
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Capo-Chichi CD, Aguida B, Chabi NW, Acapko-Ezin J, Sossah-Hiffo J, Agossou VK, Anagbla T, Zannou M, Houngbé F, Sanni A. Diversity of high risk human papilloma viruses in women treated with antiretroviral and in healthy controls and discordance with cervical dysplasia in the South of Benin. Infect Agent Cancer 2016; 11:43. [PMID: 27528886 PMCID: PMC4983786 DOI: 10.1186/s13027-016-0090-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 06/28/2016] [Indexed: 11/14/2022] Open
Abstract
Background High risk oncologic Human Papilloma Virus (HPV) is one of the leading causes of cervical cancer worldwide. We investigated HPV genotypes among women living or not with Human Immuno-deficiency Virus (HIV) in two major hospitals in the south of the republic of BENIN in the city of Cotonou. Our objective is to investigate the association of high risk-HPV to cervical dysplasia among women under stringent anti-retroviral (ARV) treatment and in controls without HIV. Methods The investigation was carried out within 1 year period in two groups of adult women: one group with HIV1 infection and under ARV therapy in the National University Hospital (CNHU-HKM) designated as CH group (n = 86); and one control group without HIV infection and attending the hospital Mènontin for routine gynecologic checkup and designated as ME group (n = 86). Cells derived from cervical uterine smears (CUS) were used for this investigation. The samples in ME group were selected to have similar lamin A/C profile with CH group. HPV genotypes were assessed by polymerase chain reaction (PCR) while lamin A/C expression profile was assessed by western blotting to corroborate the risk of cervical dysplasia. Results HPV56 is dominant in CH group while HPV66 is dominant in ME group. 31 % of women in CH group are infected with HPV compared to 23 % in ME group. Quadruple and quintuple HPV infections are more observed among CH group but not in ME group making HPV counts of 43 in CH group and 27 in ME group. Cervical dysplasia are present in 5 % (4/86) of women in CH group and in 1 % (1/86) of women in ME group at the time of CUS collection. The adjustment of the risk to develop cervical cancer in the future related to HPV infection and the total loss of lamin A/C is not significantly different in both groups. Conclusion Women living with HIV are more sensitive to multiple HPV infection but not all HPV infections generated cervical dysplasia. The effectiveness of antiretroviral therapy in CH group may reduce significantly the frequency of cervical dysplasia.
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Affiliation(s)
- Callinice D Capo-Chichi
- Molecular Biomarkers in Cancer and Nutrition (BMCN), Unit of Biochemistry and Molecular Biology (UBBM), Institute of Biomedical Sciences and Applications (ISBA), Faculty of Sciences and Technologies (FAST), University Abomey-Calavi (UAC), 04BP488, Cotonou, Benin
| | - Blanche Aguida
- Molecular Biomarkers in Cancer and Nutrition (BMCN), Unit of Biochemistry and Molecular Biology (UBBM), Institute of Biomedical Sciences and Applications (ISBA), Faculty of Sciences and Technologies (FAST), University Abomey-Calavi (UAC), 04BP488, Cotonou, Benin
| | - Nicodème W Chabi
- Molecular Biomarkers in Cancer and Nutrition (BMCN), Unit of Biochemistry and Molecular Biology (UBBM), Institute of Biomedical Sciences and Applications (ISBA), Faculty of Sciences and Technologies (FAST), University Abomey-Calavi (UAC), 04BP488, Cotonou, Benin
| | | | - Jonas Sossah-Hiffo
- Molecular Biomarkers in Cancer and Nutrition (BMCN), Unit of Biochemistry and Molecular Biology (UBBM), Institute of Biomedical Sciences and Applications (ISBA), Faculty of Sciences and Technologies (FAST), University Abomey-Calavi (UAC), 04BP488, Cotonou, Benin
| | | | | | - Marcel Zannou
- National University Hospital (CNHU-HKM), Cotonou, Benin
| | | | - Ambaliou Sanni
- Molecular Biomarkers in Cancer and Nutrition (BMCN), Unit of Biochemistry and Molecular Biology (UBBM), Institute of Biomedical Sciences and Applications (ISBA), Faculty of Sciences and Technologies (FAST), University Abomey-Calavi (UAC), 04BP488, Cotonou, Benin
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