Racial differences in human papilloma virus types amongst United States women with HIV and cervical precancer

被引:13
|
作者
Keller, Marla J. [1 ,2 ]
Burk, Robert D. [1 ,2 ]
Massad, L. Stewart [3 ]
Eltoum, Isam-Eldin [4 ]
Hessol, Nancy A. [5 ]
Anastos, Kathryn [1 ,2 ]
Xie, Xianhong [1 ,2 ]
Minkoff, Howard [6 ]
Xue, Xiaonan [1 ,2 ]
Reimers, Laura L. [7 ]
Kuniholm, Mark [8 ]
D'Souza, Gypsyamber [9 ]
Colie, Christine [10 ]
Aouizerat, Bradley [11 ]
Palefsky, Joel M. [5 ]
Strickler, Howard D. [1 ,2 ]
机构
[1] Albert Einstein Coll Med, Dept Med, 1300 Morris Pk Ave,Block Bldg,Room 512, Bronx, NY 10461 USA
[2] Montefiore Med Ctr, 1300 Morris Pk Ave,Block Bldg,Room 512, Bronx, NY 10461 USA
[3] Washington Univ, Sch Med, St Louis, MO USA
[4] Univ Alabama Birmingham, Birmingham, AL USA
[5] Univ Calif San Francisco, San Francisco, CA 94143 USA
[6] Maimonides Hosp, Brooklyn, NY 11219 USA
[7] Pfizer, New York, NY USA
[8] SUNY Albany, Albany, NY 12222 USA
[9] Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA
[10] Georgetown Univ, Med Ctr, Washington, DC 20007 USA
[11] NYU, Coll Dent, New York, NY USA
关键词
cervical precancer; ethnicity; HIV; human papillomavirus; race; (HPV)-16/18 AS04-ADJUVANTED VACCINE; HPV-6/11/16/18; VACCINE; NATURAL-HISTORY; INFECTED WOMEN; LESIONS; CANCER; RISK; COHORT; IMMUNOGENICITY; ETHNICITY;
D O I
10.1097/QAD.0000000000002005
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
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.
引用
收藏
页码:2821 / 2826
页数:6
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