Frequency and multiplicity of human papillomavirus infection in HIV-1 positive women in Italy

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• 作者：Anna Rosa Garbuglia^a ; Pierluca Piselli^b ; Daniele Lapa^a ; Catia Sias^a ; Franca Del Nonno^c ; Andrea Baiocchini^c ; Claudia Cimaglia^b ; Alessandro Agresta^b ; Maria Rosaria Capobianchi^a ; ^{maria.capobianchi@inmi.it}
• 关键词：CLART2 ; HPV clinical array human papillomavirus ; HAART ; highly active antiretroviral therapy ; HIV ; human immunodeficiency virus ; HPV ; human papillomavirus ; HR ; high risk ; LR ; low risk ; RFLP ; restriction fragment length polymorphism
• 刊名：Journal of Clinical Virology
• 出版年：2012
• 期刊代码：150_13866532
• 类别：med
• 出版时间：June, 2012
• 卷：54
• 期：2
• 页码：141-146
• 文件大小：293 K

摘要

Background

Natural history of HPV infection is altered in HIV positive women, with increased risk of cervical dysplasia. Limited data are available about the influence of HPV genotypes and HPV multiple infections on cervical disease in HIV positive women.

Objectives

We determined HPV genotype prevalence in cervical samples from 553 HIV-infected women attending the gynaecological service at 鈥淟. Spallanzani鈥?Hospital. Association of HPV multiple infections with cervical abnormalities was investigated.

Study design

MY09/MY11 consensus primers were used to detect HPV-DNA; HPV typing was performed by RFLP. A commercial array based kit was used to define unresolved RFLP patterns.

Results

HPV was detected in 244/553 (44.1%) patients, correlating with low CD4 counts (p < 0.001) and age (p = 0.001). Multiple HPV types were observed in 44.4%of cases, more frequently involving HR than LR HPV (OR = 12.8, p < 0.00001). Multiple HPV infections were associated with low CD4 counts (OR = 3.8 in CD4 < 200 vs CD4 鈮?#xA0;500 cells/mm³). Dyskaryosis was associated with decreased CD4 counts (鈮?00 vs 200-499 vs <200 cells/mm³, 蠂² for trend, p = 0.001) and with HPV types multiplicity (1 vs 2-3 vs 鈮?, 蠂² for trend, p < 0.00001). Notably, in 3 H-SIL cases only LR types were detected (HPV62, n = 2; HPV81, n = 1).

Conclusions

Multiple HPV infections, often involving HR types, are frequent in HIV-infected women. Association between multiple HPV infection, low CD4 count and cytological abnormalities supports the interplay of virological and immunological factors in cervical cancer pathogenesis. Assessment of multiple HPV infections might gain importance in cervical cancer screening, particularly in patients with predisposing factors like immuno-suppression.