期刊
AIDS
卷 32, 期 18, 页码 2821-2826出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/QAD.0000000000002005
关键词
cervical precancer; ethnicity; HIV; human papillomavirus; race
资金
- National Cancer Institute (NCI) [R01-CA-085178, R01-CA-174634, P30-CA-013330]
- UAB-MS WIHS [U01-AI-103401]
- Atlanta WIHS [U01-AI-103408]
- Bronx WIHS [U01-AI-035004]
- Brooklyn WIHS [U01-AI-031834]
- Chicago WIHS [U01-AI-034993]
- Metropolitan Washington WIHS [U01-AI-034989]
- WIHS Data Management and Analysis Center [U01-AI-042590]
- Southern California WIHS [U01-HD-032632]
- National Institute of Allergy and Infectious Diseases (NIAID)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
- National Cancer Institute (NCI)
- National Institute on Drug Abuse (NIDA)
- National Institute on Mental Health (NIMH)
- National Institute of Dental and Craniofacial Research (NIDCR)
- National Institute on Alcohol Abuse and Alcoholism (NIAAA)
- National Institute on Deafness and other Communication Disorders (NIDCD)
- NIH Office of Research on Women's Health
- UCSF CTSA [UL1-TR000004]
- Atlanta CTSA [UL1-TR000454]
- UNC CFAR [P30-AI-050410]
Objective: Recent studies reported a lower human papillomavirus 16 (HPV16) prevalence in cervical precancer among African American than Caucasian women in the general population. We assessed this relationship in women with HIV. Design: Women living with or at risk for HIV in the Women's Interagency HIV Study were followed semi-annually with Pap tests, colposcopy/histology (if indicated), and collection of cervicovaginal lavage samples for HPV testing by PCR. Racial and ethnic groups were defined using genomic Ancestry Informative Markers (AIMs). Results: Among 175 cases of cervical intraepithelial neoplasia 3 or worse (CIN-3+), 154 were diagnosed in women with HIV. African American (27%) and Hispanic (37%) cases were significantly less likely than Caucasian (62%) women to test positive for HPV16 (P = 0.01). In multivariate logistic regression models, these associations remained significant for African Americans (odds ratio = 0.13; 95% confidence interval (CI) 0.04-0.44; P = 0.001) but not Hispanics, after controlling for HIV status, CD4(+) count, history of AIDS, age, smoking, and sexual behavior. Limiting the analysis to women with HIV did not change the findings. Conclusion: HPV16 prevalence is lower in African American compared with Caucasian women with HIV and cervical precancer, independent of immune status. Future studies to determine why these racial differences exist are warranted, and whether there are similar associations between race and invasive cervical cancer in women with HIV. Further, HPV types not covered by quadrivalent and bivalent vaccines may play an especially important role in cervical precancer among HIV-positive African American women, a possible advantage to using nonavalent HPV vaccine in this population. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.
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