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J Infect. 2017 May;74(5):501-511. doi: 10.1016/j.jinf.2017.02.007. Epub 2017 Feb 28.

Human Papillomavirus infection and cervical lesions in HIV infected women on antiretroviral treatment in Thailand.

Author information

1
Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; APHP, Service de maladies infectieuses et tropicales, hôpital Saint Louis, F-75010, Paris, France; Institut National d'Etudes Démographiques (Ined), UR-5, Paris, France. Electronic address: delory.tristan@gmail.com.
2
Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; Harvard T.H. Chan School of Public Health, Boston, MA, United States.
3
Faculty of Medicine, Department of Pathology, Chiang Mai University, Chiang Mai, Thailand.
4
Ministry of Public Health, Chonburi Hospital, Chonburi, Thailand.
5
Ministry of Public Health, Nakornping Hospital, Chiang Mai, Thailand.
6
Ministry of Public Health, Chiang Kham Hospital, Chiang Kham, Thailand.
7
Ministry of Public Health, Phayao Hospital, Phayao, Thailand.
8
Ministry of Public Health, Lamphun Hospital, Lamphun, Thailand.
9
Ministry of Public Health, Hat Yai Hospital, Hat Yai, Thailand.
10
Ministry of Public Health, Lampang Hospital, Lampang, Thailand.
11
HPV National Reference Center, Pasteur Institute, Paris, France; APHP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
12
Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; Institut National d'Etudes Démographiques (Ined), UR-5, Paris, France; Harvard T.H. Chan School of Public Health, Boston, MA, United States.

Abstract

OBJECTIVES:

To estimate the prevalence and factors associated with Human Papillomavirus (HPV) infection, HPV genotypes and cytological/histological high-grade (HSIL+/CIN2+) lesions.

METHODS:

We conducted a cross-sectional study within a prospective cohort of HIV-infected women on combination antiretroviral therapy (cART). Cervical specimens were collected for cytology and HPV genotyping (Papillocheck®). Any women with High-Risk-HPV (HR-HPV), and/or potentially HR-HPV (pHR-HPV) and/or ASC-US or higher (ASC-US+) lesions were referred for colposcopy. Factors associated with HR-HPV infection and with HSIL+/CIN2+ lesions were investigated using mixed-effects logistic regression models.

RESULTS:

829 women were enrolled: median age 40.4 years, on cART for a median of 6.9 years, median CD4 cell-count 536 cells/mm3, and 788 (96%) with HIV-viral load<50copies/mL. Of 214 (26%) infected with HPV: 159 (19%) had ≥1 HR-HPV, of whom 38 (5%) HPV52, 22 (3%) HPV16, 9 (1%) HPV18; 21 (3%) had pHR-HPV, 34 (4%) low risk-HPV infection, and 56 (26%) had multiple genotypes. Younger age, low CD4 cell-counts and low education were independently associated with HR-HPV infection. 72 women (9%) had ASC-US+ and 28 (3%) HSIL+/CIN2+ lesions. HR-HPV infection was independently associated with HSIL+/CIN2+ lesions.

CONCLUSION:

The prevalence of HPV infection and of cervical lesions was low. The HPV genotype distribution supports the use of 9-valent vaccine in Thailand.

KEYWORDS:

Antiretroviral therapy; Cancer; Cervical lesions; Cross-sectional study; HIV; HPV; Thailand; Women

PMID:
28254419
DOI:
10.1016/j.jinf.2017.02.007
[Indexed for MEDLINE]

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