在肯尼亚和乌干达感染艾滋病毒的妇女中，宫颈HPV 18检测与高度宫颈发育不良有关

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports Pub Date : 2025-09-19 DOI:10.1016/j.gore.2025.101953

Miriam Nakalembe , Collins Mpamani , Jane Namugga , Carolyn Nakisige , Grace Banturaki , Phillip Tonui , Peter Itsura , Omenge Orang’o , Kapten Muthoka , Anthony Ngeresa , Beverly Musick , Aaron Ermel , Patrick Loehrer , Darron R. Brown , Yan Tong

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引用次数: 0

摘要

目的宫颈癌是由“高危”（HR） HPV引起的，是肯尼亚和乌干达妇女最常见的恶性肿瘤，也是癌症死亡的主要原因。感染艾滋病毒（WLWH）的妇女感染HR-HPV的风险很高。这项纵向、观察性队列分析旨在确定WLWH中预测宫颈上皮内瘤变2级或3级（CIN2/3）的重要因素。方法本分析的数据基于对肯尼亚和乌干达WLWH中HPV自然史和宫颈癌的研究。收集了人口统计、行为和生物学数据；对宫颈拭子进行HR-HPV DNA检测（Roche Cobas Assay）；所有WLWH均有两次宫颈活检。结果114例WLWH入组，中位年龄为38.2岁。所有WLWH在研究期间均接受抗逆转录病毒治疗。13例（11.4%）WLWH中发现CIN2/3；10例（8.8%）检出HPV 16型；HPV 18 11例（9.6%），非16/18 HR-HPV 62例（54.4%）。在本分析中，黄曲霉毒素暴露与CIN2/3无关。多变量logistic回归发现，在调整HIV病毒载量、CD4计数和Non-16/18 HR-HPV检测的影响后，宫颈HPV 18检测与CIN2/3显著相关（OR = 6.36, 95% CI = 1.36-29.75, p = 0.019）。结论11.4%的WLWH检出scin2 /3；宫颈拭子中HPV 18的检测与CIN2/3密切相关。需要在WLWH中进行更大规模的研究，以确定筛查和治疗宫颈癌的最佳方法。

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Cervical HPV 18 detection is associated with high-grade cervical dysplasia in Kenyan and Ugandan women living with HIV

Objectives

Cervical cancer, caused by “high-risk” (HR) HPV, is the most common malignancy and the leading cause of cancer deaths among women living in Kenya and Uganda. Women living with HIV (WLWH) are at a high risk for HR-HPV infection. This longitudinal, observational cohort analysis was conducted to identify factors that are important among WLWH in prediction of cervical intraepithelial neoplasia grades 2 or 3 (CIN2/3).

Methods

Data of this analysis was based on a study of HPV natural history and cervical cancer among Kenyan and Ugandan WLWH. Demographic, behavioral and biological data were collected; HR-HPV DNA testing of cervical swabs was performed (Roche Cobas Assay); all WLWH underwent cervical biopsy on two occasions.

Results

Of 114 WLWH enrolled, the median age was 38.2 years. All WLWH were receiving ART during the study. CIN2/3 was found in 13 (11.4 %) WLWH; HPV 16 was detected in 10 (8.8 %); HPV 18 in 11 (9.6 %), and Non-16/18 HR-HPV in 62 (54.4 %). Aflatoxin exposure was not associated with CIN2/3 in this analysis. A multivariable logistic regression found that cervical detection of HPV 18 was significantly associated with CIN2/3 (OR = 6.36, 95 % CI = 1.36–29.75, p = 0.019), after adjusting for the effects of HIV viral load, CD4 counts, and Non-16/18 HR-HPV detection.

Conclusions

CIN2/3 was detected in 11.4% of WLWH; HPV 18 detection in cervical swabs was strongly associated with CIN2/3. Larger studies among WLWH are needed to determine optimal approaches for screening and treatment to prevent cervical cancer.

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来源期刊

Gynecologic Oncology Reports OBSTETRICS & GYNECOLOGY-

CiteScore

2.00

自引率

0.00%

发文量

183

审稿时长

41 days

期刊介绍： Gynecologic Oncology Reports is an online-only, open access journal devoted to the rapid publication of narrative review articles, survey articles, case reports, case series, letters to the editor regarding previously published manuscripts and other short communications in the field of gynecologic oncology. The journal will consider papers that concern tumors of the female reproductive tract, with originality, quality, and clarity the chief criteria of acceptance.