Risk factors for cervical presence of human papillomavirus 
DNA among women at risk for HIV infection

Rezza, Giovanni; Giuliani, Massimo; Serraino, Diego; Branca, Margherita; Benedetto, A.; Garbuglia, Anna Rosa; Ippolito, Giuseppe; Franceschi, Silvia

doi:10.1017/s0950268898008954

Cited by 15 publications

(8 citation statements)

References 22 publications

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“…HPV DNA was detected using a nested PCR method, which has been shown previously to be significantly more sensitive for detection of all mucosal HPV genotypes (Tornesello et al, 2006). The HPV prevalence at baseline of 39.3 % in HIVpositive women was consistent with previous studies performed among HIV-infected Italian women participating in the multi-institutional DIANAIDS study Rezza et al, 1998). Overall, 20 HPV genotypes were identified, including 10 high-risk or probable high-risk viral types (types 16, 18, 31, 33, 35, 45, 52, 53, 58 and 66), four of undetermined risk (types 55, 62, 83 and 84) and six low-risk viruses (types 6, 54, 61, 70, 72 and 81).…”

Section: Discussionsupporting

confidence: 85%

Human papillomavirus (HPV) genotypes and HPV16 variants in human immunodeficiency virus-positive Italian women

Tornesello

Duraturo

Rossi

et al. 2008

Journal of General Virology

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Human immunodeficiency virus (HIV)-positive women have high rates of cervical squamous intraepithelial lesions (SIL) and concurrent human papillomavirus (HPV) infections with a variety of genotypes whose oncogenic risk is poorly documented. The prevalence and persistence of HPV genotypes and HPV16 variants were analysed in 112 HIV-positive and 115 HIV-negative Italian women. HIV-positive women were more likely than HIV-negative women to be infected by HPV at the initial examination (39.3 vs 13.9 %, P,0.001) and to have a higher period prevalence of HPV infection over a 3-year follow-up (43.8 % vs 17.4 %, P,0.001), regardless of CD4 + cell counts and anti-retroviral therapy. 18, 31, 33, 35, 45, 52, 58 and 66), among the 20 different viral genotypes identified, were predominant in HIV-positive (33.9 %) compared with HIV-negative (13.9 %) women. Among HIV-infected women, with normal cytology as well as with SIL of any grade, the most common genotypes were HPV16 followed by HPV81, isolates from 18 HIV-positive and eight HIV-negative women were classified into variant lineages based on sequencing analysis of E6 and E7 genes and the long control region. Whilst the HPV16 G350 European variant was prevalent in both HIV-positive (10.7 %) and -negative women (3.5 %), HPV16 African 2 variant was only detected in HIV-positive women (3.6 %), suggesting different sexual mixing behaviours. The increased prevalence of uncommon viral genotypes and HPV16 variants in HIV-positive Italian women underscores the need to target a wide range of HPV types in cervical screening of high-risk women. INTRODUCTIONInfection with genital human papillomaviruses (HPVs) has been established as the primary cause of cervical squamous intraepithelial lesion (SIL) and invasive cervical cancer (zur Hausen, 1987;Bosch et al., 1995; IARC, 1995;Walboomers et al., 1999). To date, more than 40 HPV genotypes have been identified in the female genital tract and have been grouped as (i) 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59), associated with a high relative risk of cervical cancer; (ii) 11, 40, 42, 43, 44, 54, 61, 70, 72, 81 and 89), associated with benign epithelial proliferations; (iii) 'probable carcinogenic' viruses (HPV types 26, 53, 66, 68, 73 and 82), associated with cervical cancer in a few casecontrol studies; and (iv) 'undetermined risk' viruses (HPV types 2a, 3, 7, 10, 27, 28, 29, 30, 32, 34, 55, 57, 62, 67, 69, 71, 74, 77, 83, 84, 85, 86, 87, 90 and 91), whose oncogenicity has not yet been determined (Muñoz et al., 2003(Muñoz et al., , 2006Smith et al., 2007).Epidemiological studies, performed mainly on human immunodeficiency virus (HIV)-negative women, have shown that, despite the high prevalence and strong association with cervical neoplasia, the majority of HPV infections with high-and low-risk types are transient and only a fraction of persistent infections progress on to highgrade SIL and invasive cancer, underscoring the interplay of a number of environmental, viral and host factors in HPV-related tumour progression (Massa...

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Section: Discussionsupporting

confidence: 85%

Human papillomavirus (HPV) genotypes and HPV16 variants in human immunodeficiency virus-positive Italian women

Tornesello

Duraturo

Rossi

et al. 2008

Journal of General Virology

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“…Alguns estudos têm evidenciado maior prevalência do HPV em pacientes infectados pelo HIV, ao mesmo tempo em que associam estas infecções às lesões precursoras do câncer cervical [8][9][10][11] . Esses estudos mostram diversas taxas de prevalência, de acordo com a população estudada, método de diagnóstico da lesão cervical e técnica empregada para avaliar a presença do HPV no trato anogenital 2,12,13 .…”

Section: Introductionunclassified

Prevalência do papilomavírus humano e seus genótipos em mulheres portadoras e não-portadoras do vírus da imunodeficiência humana

Campos¹,

Melo²,

Castilho³

et al. 2005

Rev. Bras. Ginecol. Obstet.

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Objetivo: avaliar a prevalência do HPV e seus genótipos, utilizando a técnica de reação em cadeia de polimerase (PCR), em pacientes soropositivas e soronegativas para o HIV. Métodos: estudo transversal no qual foram avaliadas 79 mulheres. Dentre elas, 41 eram portadoras do vírus HIV constituindo o grupo estudado, e 38 soronegativas para o HIV, atendidas em uma Unidade Básica de Saúde, e compuseram o grupo controle. Todas as participantes foram submetidas a teste sorológico para detecção do HIV e procuraram de forma espontânea, e pela primeira vez, o atendimento de ginecologia nos serviços mencionados. Estas mulheres responderam ao questionário padrão e foram submetidas a exame ginecológico, com coleta de material da cérvice uterina para citologia oncótica e para detecção do DNA-HPV e seus genótipos. Para análise estatística realizaram-se os testes de Kruskal-Wallis, do χ 2 ou o exato de Fisher. Foi considerada significância estatística p<0,05. Resultados: os dois grupos analisados demonstraram semelhanças quanto às características demográficas, antecedentes obstétricos e ginecológicos, exceto DST prévia. Diferenciaram-se quanto ao exame ginecológico atual e à citologia oncótica cervical. Houve diferença significante em relação à presença do DNA-HPV nos dois grupos (p<0,05). Das pacientes infectadas pelo HIV, 73,2% apresentaram resultado positivo para o DNA-HPV, comparado a 23,8% dentre as soronegativas (OR=8,79; IC 95%: 2,83-28,37). Em relação aos genótipos não se percebeu nítido predomínio de um subtipo específico de HPV em relação aos grupos infectados ou não pelo HIV, assim como foi similar a freqüência dos tipos não identificáveis. Constatouse predominância não significante (p>0,05) da infecção múltipla por HPV nas soropositivas (50,0%), e a combinação mais freqüentemente encontrada foi a dos tipos 6, 11 e 16. A infecção simples por HPV nas soronegativas ocorreu em 66,6% das pacientes. O tipo 16 foi o mais freqüentemente encontrado, representando 44,4% do total das infecções simples nos dois grupos. Conclusões: as mulheres soropositivas pelo HIV apresentaram maior prevalência do DNA-HPV na cérvice uterina, em relação às soronegativas. Não houve maior predominância de tipos específicos de HPV quando os dois grupos foram comparados. Houve tendência de infecção por múltiplos tipos de HPV nas portadoras de HIV, ao passo que a infecção simples predominou nas soronegativas.

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“…2 HPV prevalence depends largely on age and on sexual practices. [6][7][8] The prevalence of high risk HPV ranges from 11% in healthy women in Belgium, 9 20% in female university students in the United States 10 to 36% in Italian women at risk for human immunodeficiency virus (HIV) infection 11 and 46% in Spanish women in prisons. 12 The highest prevalences of HPV have been described in female sex workers (FSWs) as they have multiple risk factors for HPV infection, such as young age and multiple sexual contacts.…”

mentioning

confidence: 99%

Influence of age and geographical origin in the prevalence of high risk human papillomavirus in migrant female sex workers in Spain

Amo

González²,

Losana³

et al. 2005

Sexually Transmitted Infections

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Objectives: To estimate the prevalence and risk factors of high risk human papillomavirus (HPV) infection in migrant female sex workers (FSW) according to age and geographical origin. Methods: Cross sectional study of migrant FSW attending a sexually transmitted infection (STI) clinic in Madrid during 2002. Information on sociodemographic characteristics, reproductive and sexual health, smoking, time in commercial sex work, history of STIs, HIV, hepatitis B, hepatitis C, syphilis, and genitourinary infections was collected. High risk HPV Infection was determined through the Digene HPV Test, Hybrid Capture II. Data were analysed through multiple logistic regression. Results: 734 women were studied. Overall HPV prevalence was 39%; 61% in eastern Europeans, 42% in Ecuadorians, 39% in Colombians, 29% in sub-Saharan Africans, and 24% in Caribbeans (p = 0.057). HPV prevalence showed a decreasing trend by age; 49% under 20 years, 35% in 21-25 years,14% over 36 years% (p,0.005). In multivariate analyses, area of origin (p = 0.07), hormonal contraception in women not using condoms (OR 19.45 95% CI: 2.45 to 154.27), smoking, age, and an interaction between these last two variables (p = 0.039) had statistically significant associations with HPV prevalence. STI prevalence was 11% and was not related to age or geographical origin. Conclusions: High risk HPV prevalence in migrant FSW is elevated and related to age, area of origin, and use of oral contraceptives in women not using condoms. These data support the role of acquired immunity in the epidemiology of HPV infection and identifies migrant FSW as a priority group for sexual health promotion.H uman papillomavirus infection (HPV) is the commonest sexually transmitted infection (STI) worldwide. More than 20 types of papillomavirus have been associated with cervical cancer, the second cause of cancer related mortality in women globally.1-3 Most HPV infections are asymptomatic and resolve spontaneously with cervical smear abnormalities only occurring in those women with persistent HPV infection.4 5 The advent of molecular biology tools in HPV diagnosis has allowed us to identify HPV infection, differentiate HPV types, and discriminate groups of the population with different risks of infection.2 HPV prevalence depends largely on age and on sexual practices.6-8 The prevalence of high risk HPV ranges from 11% in healthy women in Belgium, 9 20% in female university students in the United States 10 to 36% in Italian women at risk for human immunodeficiency virus (HIV) infection 11 and 46% in Spanish women in prisons.12 The highest prevalences of HPV have been described in female sex workers (FSWs) as they have multiple risk factors for HPV infection, such as young age and multiple sexual contacts. [13][14][15][16] There is wide heterogeneity in reported HPV prevalences in FSW from studies in different geographical areas; 43% in Mexico, 14 48% in Japan, 15 and 63% in Calcutta, India. 16 Over the last few years, an increasing proportion of the FSWs in European countries are mi...

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Risk factors for cervical presence of human papillomavirus DNA among women at risk for HIV infection

Cited by 15 publications

References 22 publications

Human papillomavirus (HPV) genotypes and HPV16 variants in human immunodeficiency virus-positive Italian women

Human papillomavirus (HPV) genotypes and HPV16 variants in human immunodeficiency virus-positive Italian women

Prevalência do papilomavírus humano e seus genótipos em mulheres portadoras e não-portadoras do vírus da imunodeficiência humana

Influence of age and geographical origin in the prevalence of high risk human papillomavirus in migrant female sex workers in Spain

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