High‐risk human papillomavirus infection in HIV‐positive African women living in Europe

Konopnicki, Déborah; Manigart, Yannick; Gilles, Christine; Barlow, Patricia; Marchin, Jérôme de; Feoli, Francesco; Larsimont, Denis; Delforge, Marc; Wit, Stéphane De; Clumeck, Nathan

doi:10.7448/ias.16.1.18023

Cited by 27 publications

(23 citation statements)

References 32 publications

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“…These findings highlighted that the HPV prevalence in the HIVpositive Moroccan women was significantly higher than observed in the general population (15.7%-43.1%) [6][7][8]. This seems to be in line with other previous reports which documents high proportion of HIVinfected women carrying varieties of HR-HPV types [27,28]. Furthermore, previous reports showed that HIV-infected women had a seven-fold increased rate of persistence of HR-HPV [29].…”

Section: Discussionsupporting

confidence: 80%

The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study

Ouladlahsen¹,

Fayssel

Bensghir³

et al. 2018

J Infect Dev Ctries

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Introduction: Women infected with human immunodeficiency virus (HIV) have a higher risk of contracting human papillomavirus (HPV) infections and are more prone to develop cervical cancer. The objective of this study was to determine the prevalence of HPV and its association with risk factors among Moroccan women living with HIV/AIDS. Methodology: We enrolled 251 HIV-infected non-pregnant women in Morocco from February 2013 to September 2016. Sociodemographic, lifestyles, behavioral and clinical data were collected. Polymerase chain reaction followed by sequencing were performed for molecular detection and HPV genotyping in cervical samples, respectively. Results: Abnormal cervical smears were found in 34/246 patients (13.82%). The overall prevalence of HPV was 74.50%. HPV 58 was the most prevalent (39.29%) followed by HPV 18 (10.71%), HPV 70 (8.93%), HPV 33 (7.14%), HPV 6 (6.25%) and other genotypes (< 3%). Overall, high-risk HPV (HR-HPV) types were present in 75% (84/112) of patients and the prevalence of HR-HPV types in samples with abnormal Pap was higher than in normal Pap (55/83, 66.27% vs. 28/83,33.33%, p < 0.0001). Univariate analyses showed that none of the socio-demographic and behaviors factors was associated with HPV infection. Moreover, Pap results were not affected by HPV status (p = 0.532). Whereas, CD4 T-cell counts above 200/mm 3 at enrolment were apparently not protective to HPV infection. We found a high prevalence of HPV infection and HR-HPV types among HIV-positive women that significantly associated with abnormal Pap. Conclusion: Our findings suggest a high prevalence of HPV infection with high-risk types was observed among HIV-positive women warrant to implement a regular screening by Pap smear.

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Section: Discussionsupporting

confidence: 80%

The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study

Ouladlahsen¹,

Fayssel

Bensghir³

et al. 2018

J Infect Dev Ctries

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“…A follow-up to that study will determine whether precancerous lesions were missed on cytology smears in these women. A prospective longitudinal study of a large cohort of 652 HIV-infected women primarily of African origin but living in Belgium and with normal cervical cytology had similar findings (185). The prevalence of high-risk HPV infection at first screen was 42.8%, with the majority of positive results occurring in women under age 30 and in those with CD4 counts less than 200 cells/l but with prevalence remaining higher than in the general population across each age and CD4 count group.…”

Section: High-risk Hpv Detection As a First-line Test In Primary Cervmentioning

confidence: 66%

“…These factors contribute to the finding that HIV-infected women are three to five times more likely than HIVuninfected women to develop cervical dysplasia (183). HPV prevalence in HIV-infected populations is more than three times the estimated prevalence of 12% found in the general population and ranges from about 31% to 57%, with higher percentages in Africa than in North America or Western Europe (185). A pilot study conducted in Jos, Nigeria, evaluated a cohort of 97 HIV-infected women age 21 to 49 with normal cytology (186).…”

Section: High-risk Hpv Detection As a First-line Test In Primary Cervmentioning

confidence: 91%

Human Papillomavirus Laboratory Testing: the Changing Paradigm

2016

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SUMMARYHigh-risk human papillomaviruses (HPVs) cause essentially all cervical cancers, most anal and oropharyngeal cancers, and some vaginal, vulvar, and penile cancers. Improved understanding of the pathogenesis of infection and the availability of newer tests are changing the approach to screening and diagnosis. Molecular tests to detect DNA from the most common high-risk HPVs are FDA approved for use in conjunction with cytology in cervical cancer screening programs. More-specific tests that detect RNA from high-risk HPV types are now also available. The use of molecular tests as the primary screening tests is being adopted in some areas. Genotyping to identify HPV16 and -18 has a recommended role in triaging patients for colposcopy who are high-risk HPV positive but have normal cytology. There are currently no recommended screening methods for anal, vulvar, vaginal, penile, or oropharyngeal HPV infections. HPV testing has limited utility in patients at high risk for anal cancer, but p16 immunohistochemistry is recommended to clarify lesions in tissue biopsy specimens that show moderate dysplasia or precancer mimics. HPV testing is recommended for oropharyngeal squamous cell tumors as a prognostic indicator. Ongoing research will help to improve the content of future guidelines for screening and diagnostic testing.

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“…HPV infection, especially by HPV-16, has been commonly identified as a risk factor contributing to the onset of head and neck cancers, predominantly those of the oropharynx, tonsils, and the base of the tongue [31]. A recent cohort study found that the relative risk of carrying HPV decreased proportionately by 11% for each 100 CD4 cells/μL increase, suggesting plausible co-infection of HPV in immunosuppressed including HIV-positive individuals, as well as attenuating risk of HPV infection with improved immune function [37]. The large number of HIV-positive head and neck cancer cases in this study may be due to this co-infection, though more complete HPV status data in ORCI medical records will be necessary to confirm this association.…”

Section: Discussionmentioning

confidence: 99%

Changing Patterns of lung, liver, and head and neck non-AIDS-defining cancers relative to HIV status in Tanzania between 2002-2014

Campbell

Soliman

Kahesa

et al. 2016

Infect Agents Cancer

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BackgroundTanzania, like other low-income countries, has an increasing cancer burden that remains underestimated. Infection-associated malignancies, particularly HIV-infection, represent a great proportion of cancer burden in Tanzania and throughout Africa. Availability of HIV treatment and improved survival of HIV patients are suggested factors related to increasing prevalence of non-AIDS-defining cancers (NADCs). This study examined patterns of NADCs and proportions of HIV-positivity at the Ocean Road Cancer Institute (ORCI).MethodsWe reviewed logbooks of all ORCI patients diagnosed and/or treated for lung, liver, and head and neck cancers during 2002–2014. The number of total cancers diagnosed at ORCI during this period was used to calculate proportions of NADCs. We abstracted medical records to obtain demographic and clinical profiles and HIV status information for 1127 patients diagnosed or treated during 2010–2014. Trends in numbers and proportions of NADCs were analyzed using Joinpoint regression. Characteristics of NADC patients were analyzed using multinomial logistic regression.ResultsNADCs diagnosed at ORCI increased by 33.8% from 2002 to 2014 while the proportion of NADCs relative to all cancers significantly decreased from 6.8% in 2002 to 5.6% in 2014 (APC = -2.74%). Numbers and proportions of lung and liver cancers increased compared to all cancer diagnoses from 2002 to 2014. The number of head and neck cancers increased while decreasing proportionally compared to all cancer diagnoses from 2002 to 2014. Among patients with pathologically confirmed NADCs between 2010 and 2014, HIV prevalence showed a non-statistically significant decrease from 8.1 to 7.1% (APC = -3.77%).ConclusionsAbsolute numbers of lung, liver, and head and neck cancers increased at ORCI by 1/3 since 2002. Improving survivorship of HIV patients and varying immunodeficiency status may have contributed to the increasing number of NADCs. Total cancer diagnoses nearly doubled during this period, leading to a smaller relative proportion of NADCs diagnosed in 2014 compared to 2002. Late- stage diagnosis and short survival of NADCs included this study may explain possible underestimation and smaller increase in proportion of these particular NADCs compared to other NADCs studied in Tanzania. The slight decrease in proportion of HIV-positive NADC patients during 2010–2014 may suggest increasing patient longevity and more effective HIV management in Tanzania.

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High‐risk human papillomavirus infection in HIV‐positive African women living in Europe

Cited by 27 publications

References 32 publications

The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study

The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study

Human Papillomavirus Laboratory Testing: the Changing Paradigm

Changing Patterns of lung, liver, and head and neck non-AIDS-defining cancers relative to HIV status in Tanzania between 2002-2014

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