Samuel Martin Sosso, Michel Carlos Tommo Tchouaket, Joseph Fokam, Rachel Kamgaing Simo, Ezechiel Ngoufack Jagni Semengue, Zacharie Sando, Judith Torimiro, Aline Tiga, Elise Elong Lobe, Georgia Ambada, Achille Nange, Alex Durand Nka, Collins Chenwi, Aissatou Abba, Aude Christelle Ka'e, Nadine Fainguem, Marie Krystel Nnomo Zam, Bouba Yagai, Serge Clotaire Billong, Vittorio Colizzi, Alexis Ndjolo
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引用次数: 0
Abstract
Cervical lesions, induced by high-risk oncogenic human papillomavirus (HR-HPV), in the context of HIV remains a global health challenge. We determined the effect of HR-HPV on the development of cervical lesions in women with and without HIV infection. A cross-sectional analytical study was conducted among 257 women living in Cameroon. HIV serology, HR-HPV genotyping and cervico-vaginal smear (CVS) were performed for all participants; among those declared HIV positive, plasma HIV viral load and CD4 count were measured. Statistical analyses were performed using Graph Pad version 6.0; P#x003C;0.05 was considered statistically significant. The mean age of the participants in our study was 37±6.5 years. According to HIV serology, 184 (71.59%) were HIV-positive vs. 73 (28.40%) HIV-negative. Among the HIV-positive women, the median CD4 count was 438 [IQR: 317-597] cells/mm3 and the median viremia was #x003C;40 [IQR: #x003C;40-2318] copies/ml. After successful genotyping, the prevalence of HR-HPV was 36.32% (73/201), with a significantly higher proportion in HIV-infected individuals (41.98% (55/131) vs. 25.71% (18/70); P=0.02; OR=2.1). The overall rate of cervical lesions was 23.34% (60/257), with a non-significantly higher proportion in HIV-infected participants (25.00% (46/184) vs. 19.17% (14/73); P=0.31). Relevantly, the presence of HR-HPV was significantly associated with cervical lesions (P#x003C;0.0001; OR=5.07), with a higher odds of cervical lesion in HIV-positive individuals (P#x003C;0.0001 and OR=5.67) compared to HIV-negative individuals (P=0.03 and OR=3.83). Although oncogenic HPV appears to be an independent factor in the development of cervical lesions, this study reveals higher odds of cervical lesions among HIV/HPV co-infection than in HPV infection alone.
背景:高危致癌人乳头瘤病毒(HR-HPV)引起的宫颈病变在HIV的背景下仍然是一个全球性的健康挑战。我们确定了HR-HPV对感染和未感染HIV的妇女宫颈病变发展的影响。方法:对生活在喀麦隆的257名妇女进行横断面分析研究。对所有参与者进行HIV血清学、HR-HPV基因分型和宫颈阴道涂片(CVS);在那些被宣布为HIV阳性的人中,测量了血浆HIV病毒载量和CD4计数。使用Graph Pad 6.0版进行统计分析;p<0.05被认为具有统计学意义。结果:本研究参与者的平均年龄为37±6.5岁。根据HIV血清学,184人(71.59%)HIV阳性,73人(28.40%)HIV阴性。在HIV阳性女性中,CD4计数中位数为438[IQR:317-597]个细胞/mm3,病毒血症中位数为<40[IQR:<40-2318]个拷贝/mL。成功进行基因分型后,HR-HPV的患病率为36.32%(73/201),在HIV感染者中的比例明显更高(41.98%(55/131),而在25.71%(18/70);p=0.02;OR=2.1)。宫颈病变的总发生率为23.34%(60/257),HIV感染者的比例并不显著更高(25.00%(46/184)对19.17%(14/73);p=0.31)。相关的是,HR-HPV的存在与宫颈病变显著相关(p<0.0001;OR=5.07),与HIV阴性个体(p=0.03和OR=3.83)相比,HIV阳性个体发生宫颈病变的几率更高(p<0.001和OR=5.67)。结论:尽管致癌HPV似乎是宫颈病变发展的独立因素,这项研究显示,与单独感染HPV相比,HIV/HPV联合感染者发生宫颈病变的几率更高。
期刊介绍:
The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.