Sonia Menon 1, Stanley Luchters 2 3 4, Rodolfo Rossi 5, Steven Callens 2 6, Mandaliya Kishor 7, Johannes Bogers 2 8, Davy Vanden Broeck 2 8
Affiliations
- 1International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000, Ghent, Belgium. soniasimonemenon@gmail.com.
- 2International Centre for Reproductive Health (ICRH), Department of Obstetrics and Gynaecology, Ghent University, De Pintelaan 185 P3, 9000, Ghent, Belgium.
- 3Burnet Institute, Melbourne, VIC, Australia.
- 4Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
- 5Primary Health Care Services, International Committee of the Red Cross (ICRC), Geneva, Switzerland.
- 6Department of Internal Medicine & Infectious diseases, University Hospital, Ghent, Belgium.
- 7ICRH, P.O.Box 91109, Mombasa, 80103, Kenya.
- 8Faculty of Medicine and Health Sciences, AMBIOR (Applied Molecular Biology Research Group), Laboratory of Cell Biology & Histology, University of Antwerp, Melbourne, Belgium.
PMID: 29587796 PMCID: PMC5870930
DOI: 10.1186/s12985-018-0961-3
Abstract
Background: Women living with HIV are at increased risk to be co-infected with HPV, persistent high-risk (HR) human papillomavirus (HPV) infection and increased HR HPV viral load, which make them more at risk for cervical cancer. Despite their inherent vulnerability, there is a scarcity of data on potential high risk (pHR) and HR HPV genotypes in HIV- infected women with cervical dysplasia and HPV-type specific viral load in this population in Sub Saharan Africa. The aim of this analysis of HIV-infected women was to explore the virological correlates of high-grade cervical dysplasia (CIN 2+) in HIV-infected women, thereby profiling HPV genotypes.
Method: This analysis assesses baseline data obtained from a cohort study of 74 HIV-infected women with abnormal cytology attending a Comprehensive Care Centre for patients with HIV infection in Mombasa, Kenya. Quantitative real-time PCR was used for HPV typing and viral load.
Results: CIN 2 was observed in 16% (12/74) of women, CIN 3 in 23% (17/74), and, invasive cervical carcinoma (ICC) in 1% (1/74) of women. In women with CIN 3+, HPV 16 (44%), HPV 56 (33%), HPV 33 and 53 (HPV 53 (28%) were the most prevalent genotypes. HPV 53 was observed as a stand-alone HPV in one woman with ICC. A multivariate logistic regression adjusting for age, CD4 count and HPV co-infections suggested the presence of HPV 31 as a predictor of CIN 2+ (adjusted odds ratio [aOR]:4.9; p = 0.05; 95% (Confidence Interval) [CI]:1.03-22.5). Women with CIN2+ had a significantly higher viral log mean of HPV 16, (11.2 copies/ 10,000 cells; 95% CI: 9.0-13.4) than with CIN 1.
Conclusion: The high prevalence of HPV 53 in CIN 3 and as a stand-alone genotype in the patient with invasive cervical cancer warrants that its clinical significance be further revisited among HIV-infected women. HPV 31, along with elevated means of HPV 16 viral load were predictors of CIN 2 + .
Keywords: CIN 2 +; Co-infections; HPV viral load; Human papilloma virus; Kenya; Pairings; Potentially high risk/high-risk HPV genotypes.
Conflict of interest statement
Competing interest
The authors declare that they have no competing interests.
Ethics approval and consent to participate
Ethical approval for the study was given by the Ethics Committee of Ghent University Hospital and from the Ethics and Research Committee of the Kenyatta National Hospital (Ref number: (Ref: KNH-ERC/01/3618).
Consent for publication
Written informed consent was obtained from all participants. Illiterate women elected a person who signed on their behalf after thorough explanation.
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