Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark - the SHADE.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
22 Aug 2019
Historique:
received: 02 05 2019
accepted: 13 08 2019
entrez: 24 8 2019
pubmed: 24 8 2019
medline: 28 10 2019
Statut: epublish

Résumé

Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)). This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.

Sections du résumé

BACKGROUND BACKGROUND
Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark.
METHODS METHODS
From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL.
RESULTS RESULTS
Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)).
CONCLUSIONS CONCLUSIONS
This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.

Identifiants

pubmed: 31438877
doi: 10.1186/s12879-019-4377-5
pii: 10.1186/s12879-019-4377-5
pmc: PMC6706931
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

740

Subventions

Organisme : The Danish Cancer Society and the AIDS Foundation
ID : Not applicable
Organisme : The Aragon Foundation
ID : Not applicable
Organisme : The Foundation of Aase and Ejnar Danielsens
ID : Not applicable
Organisme : The Foundation of Anna and Preben Simonsen
ID : Not applicable

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Auteurs

Kristina Thorsteinsson (K)

Department of Infectious Diseases, Hvidovre Hospital, Kettegaards Allé 30, 2650, Hvidovre, Denmark. kristina.thorsteinsson@gmail.com.

Steen Ladelund (S)

Clinical Research Center, Copenhagen University Hospital, Hvidovre, Denmark.

Merete Storgaard (M)

Department of Infectious Diseases, Aarhus University Hospital, Skejby, Denmark.

Terese L Katzenstein (TL)

Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Isik Somuncu Johansen (IS)

Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.

Gitte Pedersen (G)

Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.

Frederikke Falkencrone Rönsholt (FF)

Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Lars Nørregård Nielsen (LN)

Department of Infectious Diseases, Nordsjællands Hospital, Hillerød, Denmark.

Lisbeth Nilas (L)

Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Department of Obstetrics and Gynaecology, Copenhagen University Hospital, Hvidovre, Denmark.

Maria Franzmann (M)

Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark.

Niels Obel (N)

Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Anne-Mette Lebech (AM)

Department of Infectious Diseases, Hvidovre Hospital, Kettegaards Allé 30, 2650, Hvidovre, Denmark.
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.

Jesper Bonde (J)

Molecular Pathology Laboratory, Department of Pathology, Copenhagen University Hospital, Hvidovre, Denmark.

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