Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV
Abstract Background Persistent infection with high-risk human papillomavirus (hrHPV) is a critical step in cervical carcinogenesis. We report on type-specific hrHPV persistence, clearance and incidence among screen-positive Rwandan women living with HIV (WLWH). Methods This was a nested analysis fro...
Main Authors: | , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2021-02-01
|
Series: | Infectious Agents and Cancer |
Subjects: | |
Online Access: | https://doi.org/10.1186/s13027-021-00355-6 |
id |
doaj-0618e94e2ce040c3bcd1dd0d167e5768 |
---|---|
record_format |
Article |
spelling |
doaj-0618e94e2ce040c3bcd1dd0d167e57682021-02-21T12:09:29ZengBMCInfectious Agents and Cancer1750-93782021-02-011611910.1186/s13027-021-00355-6Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIVGad Murenzi0Patrick Tuyisenge1Faustin Kanyabwisha2Athanase Munyaneza3Benjamin Muhoza4Gallican Kubwimana5Anthere Murangwa6Leon Mutesa7Kathryn Anastos8Philip E. Castle9Rwanda Military HospitalRwanda Military HospitalRwanda Military HospitalRwanda Military HospitalRwanda Military HospitalRwanda Military HospitalRwanda Military HospitalResearch for Development (RD Rwanda)Center for Human Genetics, College of Medicine and Health Sciences, University of RwandaAlbert Einstein College of MedicineAbstract Background Persistent infection with high-risk human papillomavirus (hrHPV) is a critical step in cervical carcinogenesis. We report on type-specific hrHPV persistence, clearance and incidence among screen-positive Rwandan women living with HIV (WLWH). Methods This was a nested analysis from a large cervical cancer screening study of ~ 5000 Rwandan WLWH. Women who tested positive for hrHPV and/or visual inspection with acetic acid were referred to colposcopy. For a subset of women (n = 298) who were ≥ 6 months delayed in receiving colposcopy, we tested their screening and colposcopy visit specimens using the AmpFire HPV genotyping assay that tests 14 hrHPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) individually. Results The mean, median (interquartile range [IQR]) and range of time between the screening and colposcopy visits were 644, 650 (490–820.5) and 197–1161 days, respectively. Mean, median (IQR) and range of age at the screening visit were 38, 37 (34–43) and 30–54 years, respectively. Two-hundred eighty-three (95.0%) had CD4 count (cells per mm3) data available at baseline with mean, median (IQR) and range of 592, 513 (346–717) and 0–7290, respectively. Two-hundred thirty-five WLWH were positive for at least one hrHPV type at the screening visit, of whom 50.2% had at least one HPV type-specific infection persist; 37.2% of all HPV infections detected at the screening visit persisted. Compared to all other HPV types in aggregate, HPV16 (vs. non-HPV16 types) (47.7%, p = 0.03) and HPV33 (vs. non-HPV33 types) (56.7%, p = 0.03) were significantly more likely, and HPV39 (vs. non-HPV39 types) (6.7%, p = 0.01), HPV51 (vs. non-HPV51 types) (15.6%, p < 0.01), and HPV66 (vs. non-HPV66 types (17.9%, p = 0.04) were significantly less likely, to persist. Lower CD4 counts were associated with having any persistent hrHPV infection (ptrend = 0.04) and multiple persistent hrHPV infections (ptrend = 0.04). Conclusion There is a significant proportion of WLWH with persistent hrHPV infection, emphasizing the need to vaccinate them against HPV prior to becoming sexually active.https://doi.org/10.1186/s13027-021-00355-6Hr-HPV persistenceIncidenceHIVHPV vaccine |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gad Murenzi Patrick Tuyisenge Faustin Kanyabwisha Athanase Munyaneza Benjamin Muhoza Gallican Kubwimana Anthere Murangwa Leon Mutesa Kathryn Anastos Philip E. Castle |
spellingShingle |
Gad Murenzi Patrick Tuyisenge Faustin Kanyabwisha Athanase Munyaneza Benjamin Muhoza Gallican Kubwimana Anthere Murangwa Leon Mutesa Kathryn Anastos Philip E. Castle Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV Infectious Agents and Cancer Hr-HPV persistence Incidence HIV HPV vaccine |
author_facet |
Gad Murenzi Patrick Tuyisenge Faustin Kanyabwisha Athanase Munyaneza Benjamin Muhoza Gallican Kubwimana Anthere Murangwa Leon Mutesa Kathryn Anastos Philip E. Castle |
author_sort |
Gad Murenzi |
title |
Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV |
title_short |
Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV |
title_full |
Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV |
title_fullStr |
Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV |
title_full_unstemmed |
Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV |
title_sort |
type-specific persistence, clearance and incidence of high-risk hpv among screen-positive rwandan women living with hiv |
publisher |
BMC |
series |
Infectious Agents and Cancer |
issn |
1750-9378 |
publishDate |
2021-02-01 |
description |
Abstract Background Persistent infection with high-risk human papillomavirus (hrHPV) is a critical step in cervical carcinogenesis. We report on type-specific hrHPV persistence, clearance and incidence among screen-positive Rwandan women living with HIV (WLWH). Methods This was a nested analysis from a large cervical cancer screening study of ~ 5000 Rwandan WLWH. Women who tested positive for hrHPV and/or visual inspection with acetic acid were referred to colposcopy. For a subset of women (n = 298) who were ≥ 6 months delayed in receiving colposcopy, we tested their screening and colposcopy visit specimens using the AmpFire HPV genotyping assay that tests 14 hrHPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) individually. Results The mean, median (interquartile range [IQR]) and range of time between the screening and colposcopy visits were 644, 650 (490–820.5) and 197–1161 days, respectively. Mean, median (IQR) and range of age at the screening visit were 38, 37 (34–43) and 30–54 years, respectively. Two-hundred eighty-three (95.0%) had CD4 count (cells per mm3) data available at baseline with mean, median (IQR) and range of 592, 513 (346–717) and 0–7290, respectively. Two-hundred thirty-five WLWH were positive for at least one hrHPV type at the screening visit, of whom 50.2% had at least one HPV type-specific infection persist; 37.2% of all HPV infections detected at the screening visit persisted. Compared to all other HPV types in aggregate, HPV16 (vs. non-HPV16 types) (47.7%, p = 0.03) and HPV33 (vs. non-HPV33 types) (56.7%, p = 0.03) were significantly more likely, and HPV39 (vs. non-HPV39 types) (6.7%, p = 0.01), HPV51 (vs. non-HPV51 types) (15.6%, p < 0.01), and HPV66 (vs. non-HPV66 types (17.9%, p = 0.04) were significantly less likely, to persist. Lower CD4 counts were associated with having any persistent hrHPV infection (ptrend = 0.04) and multiple persistent hrHPV infections (ptrend = 0.04). Conclusion There is a significant proportion of WLWH with persistent hrHPV infection, emphasizing the need to vaccinate them against HPV prior to becoming sexually active. |
topic |
Hr-HPV persistence Incidence HIV HPV vaccine |
url |
https://doi.org/10.1186/s13027-021-00355-6 |
work_keys_str_mv |
AT gadmurenzi typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT patricktuyisenge typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT faustinkanyabwisha typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT athanasemunyaneza typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT benjaminmuhoza typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT gallicankubwimana typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT antheremurangwa typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT leonmutesa typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT kathrynanastos typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv AT philipecastle typespecificpersistenceclearanceandincidenceofhighriskhpvamongscreenpositiverwandanwomenlivingwithhiv |
_version_ |
1724258338606153728 |