A cross-sectional study of high-risk human papillomavirus clustering and cervical outcomes in HIV-infected women in Rio de Janeiro, Brazil

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorCASTILHO, Jessica L.
dc.contributor.authorLEVI, Jose Eduardo
dc.contributor.authorLUZ, Paula M.
dc.contributor.authorCAMBOU, Mary Catherine
dc.contributor.authorVANNI, Tazio
dc.contributor.authorANDRADE, Angela de
dc.contributor.authorDERRICO, Monica
dc.contributor.authorVELOSO, Valdilea G.
dc.contributor.authorGRINSZTEJN, Beatriz
dc.contributor.authorFRIEDMAN, Ruth K.
dc.date.accessioned2015-10-26T16:50:11Z
dc.date.available2015-10-26T16:50:11Z
dc.date.issued2015
dc.description.abstractBackground: In Brazil, the rate of cervical cancer remains high despite the availability of screening programs. With ongoing vaccine development and implementation, information on the prevalence of specific HPV types is needed, particularly among high-risk populations, such as HIV-infected women. Methods: We performed a study of HIV-infected women in Rio de Janeiro, Brazil, who underwent cervical HPV genotype testing between 2005-2013. We examined the prevalence of high-risk HPV types and the patterns of high-risk HPV type clustering. Using logarithmic binomial regression, we estimated the risk of abnormal cytology by HPV genotype result. Results: Of the 562 women included, 498 (89 %) had at least one HPV type detected. 364 women (65 %) had at least one high-risk HPV type detected and 181 (32 %) had more than one high-risk type detected. HPV 58 was the most frequent HPV type detected overall (prevalence 19.8 % [95 % confidence interval 16.4-23.1]), followed by HPV 53 (prevalence 15.5 % [12.5-18.5]) and HPV 16 (prevalence 13 % [10.2-15.8]). Women infected with more than one high-risk HPV type were younger, had lower CD4+ lymphocyte counts, and were more likely to be infected with HPV 16 or 18. In adjusted analyses, presence of more than one high-risk HPV type was associated with a two-fold increased risk of abnormal cytology after adjusting for presence of individual high-risk type, age, and CD4+ lymphocyte count (adjusted prevalence ratios 1.88-2.07, all p < 0.001). No single high-risk HPV type was statistically associated with abnormal cytology after adjusting for the presence of more than one high-risk HPV type. Conclusions: In the largest study of cervical HPV genotypes among HIV-infected women in Latin America, infection by high-risk HPV types other than 16 or 18 and infection by more than one high-risk HPV types were common. Infection by more than one high-risk type was more strongly associated with abnormal cervical cytology than any individual high-risk HPV type, highlighting the need for multi-valent HPV vaccines.
dc.description.indexMEDLINE
dc.description.sponsorshipNational Institutes of Health (United States) [T32 AI007474, K24 AI65298, UO1 AI069923, R25 MH087222]
dc.description.sponsorshipNational Council of Technological and Scientific Development (Brazil)
dc.description.sponsorshipResearch Agency of the State of Rio de Janeiro (Brazil)
dc.description.sponsorshipBrazilian National STD/AIDS Program (Brazil)
dc.identifier.citationBMC CANCER, v.15, article ID 478, 10p, 2015
dc.identifier.doi10.1186/s12885-015-1486-4
dc.identifier.issn1471-2407
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/12020
dc.language.isoeng
dc.publisherBIOMED CENTRAL LTD
dc.relation.ispartofBMC Cancer
dc.rightsopenAccess
dc.rights.holderCopyright BIOMED CENTRAL LTD
dc.subjectHPV
dc.subjectWomen
dc.subjectHIV
dc.subjectCervical cancer
dc.subjectEpidemiology
dc.subject.otheractive antiretroviral therapy
dc.subject.otherhuman-immunodeficiency-virus
dc.subject.othersquamous intraepithelial lesions
dc.subject.otherpositive women
dc.subject.othercytological abnormalities
dc.subject.othercell count
dc.subject.otherhpv types
dc.subject.otherprevalence
dc.subject.othergenotypes
dc.subject.othercancer
dc.subject.wosOncology
dc.titleA cross-sectional study of high-risk human papillomavirus clustering and cervical outcomes in HIV-infected women in Rio de Janeiro, Brazil
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryisous
hcfmusp.author.externalCASTILHO, Jessica L.:Vanderbilt Univ, Div Infect Dis, Sch Med, Nashville, TN 37235 USA
hcfmusp.author.externalLUZ, Paula M.:Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalCAMBOU, Mary Catherine:Univ Calif Los Angeles, David Geffen Sch Med, Div Infect Dis, Los Angeles, CA 90095 USA; Univ Calif Los Angeles, David Geffen Sch Med, Program Global Hlth, Los Angeles, CA 90095 USA
hcfmusp.author.externalVANNI, Tazio:Minist Saude, Dept Ciencia & Tecnol, Brasilia, DF, Brazil
hcfmusp.author.externalANDRADE, Angela de:Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalDERRICO, Monica:Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalVELOSO, Valdilea G.:Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalGRINSZTEJN, Beatriz:Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.author.externalFRIEDMAN, Ruth K.:Fundacao Oswaldo Cruz, Inst Nacl Infectol Evandro Chagas, Rio De Janeiro, Brazil
hcfmusp.citation.scopus17
hcfmusp.contributor.author-fmusphcJOSE EDUARDO LEVI
hcfmusp.description.articlenumber478
hcfmusp.description.volume15
hcfmusp.origemWOS
hcfmusp.origem.pubmed26100400
hcfmusp.origem.scopus2-s2.0-84934934252
hcfmusp.origem.wosWOS:000356580200001
hcfmusp.publisher.cityLONDON
hcfmusp.publisher.countryENGLAND
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