HPV Infection in a Cohort of HIV-Positive Men and Women: Prevalence of Oncogenic Genotypes and Predictors of Mucosal Damage at Genital and Oral Sites.

Journal of sexually transmitted diseases Pub Date : 2013-01-01 Epub Date: 2013-03-05 DOI:10.1155/2013/915169
Giulia Marchetti, Laura Comi, Teresa Bini, Marco Rovati, Francesca Bai, Barbara Cassani, Marina Ravizza, Marco Tarozzi, Alessandro Pandolfo, Serena Dalzero, Enrico Opocher, Solange Romagnoli, Antonio Carrassi, Silvano Bosari, Antonella d'Arminio Monforte
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引用次数: 12

Abstract

The aim of this study was to assess the prevalence of HPV infection and determinants of abnormal cytology in HIV-positive patients. In a cross-sectional study, patients of both sexes, asymptomatic for HPV, underwent anorectal (men)/cervical (women) and oral swabs. Cytology and HPV-PCR detection/genotyping (high- and low-risk genotypes, HR-LR/HPV) were performed. A total of 20% of the 277 enrolled patients showed oral HPV, with no atypical cytology; in men, anal HPV prevalence was 81% with 64% HR genotypes. In women, cervical HPV prevalence was 58% with 37% HR-HPV. The most frequent genotypes were HPV-16 and HPV-18; 37% of men and 20% of women harbored multiple genotypes. Also, 47% of men showed anal squamous intraepithelial lesions (SILs); 6% had high- and 35% low-grade SILs (HSILs/LSILs); 5% had atypical squamous cells of undetermined significance (ASC-US). HR-HPV was independently associated with anal-SIL in men (P = 0.039). Moreover, 37% of women showed cervical SIL: 14 ASC-US, 15 LSILs, 4 HSILs, and 1 in situ cancer. The presence of both LR and HR-HPV in women was independently associated with SIL (P = 0.003 and P = 0.0001). HR-HPV and atypical cytology were frequently identified in our cohort. HPV screening should be mandatory in HIV-infected subjects, and vaccine programs for HPV-negative patients should be implemented.

Abstract Image

一组hiv阳性男性和女性的HPV感染:致癌基因型的患病率和生殖器和口腔粘膜损伤的预测因子
本研究的目的是评估艾滋病毒阳性患者中HPV感染的患病率和异常细胞学的决定因素。在一项横断面研究中,无HPV症状的两性患者接受了肛门直肠(男性)/宫颈(女性)和口腔拭子检查。进行细胞学和HPV- pcr检测/基因分型(高风险和低风险基因型,HR-LR/HPV)。277例入组患者中,有20%的患者表现为口腔HPV,没有不典型细胞学;在男性中,肛门HPV患病率为81%,HR基因型为64%。在女性中,宫颈HPV患病率为58%,HR-HPV患病率为37%。最常见的基因型是HPV-16和HPV-18;37%的男性和20%的女性携带多种基因型。此外,47%的男性表现为肛门鳞状上皮内病变(SILs);6%为高级别SILs, 35%为低级别SILs (HSILs/LSILs);5%为不典型鳞状细胞,意义不明(ASC-US)。HR-HPV与男性肛门sil独立相关(P = 0.039)。此外,37%的女性显示宫颈SIL: 14例ASC-US, 15例LSILs, 4例HSILs和1例原位癌。女性中LR和HR-HPV的存在与SIL独立相关(P = 0.003和P = 0.0001)。HR-HPV和非典型细胞学在我们的队列中经常被发现。在hiv感染者中,HPV筛查应该是强制性的,HPV阴性患者的疫苗接种项目应该实施。
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