Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark: The SHADE

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  • Kristina Thorsteinsson
  • Steen Ladelund
  • Merete Storgaard
  • Terese L. Katzenstein
  • Isik Somuncu Johansen
  • Gitte Pedersen
  • Frederikke Falkencrone Rönsholt
  • Lars Nørregård Nielsen
  • Lisbeth Nilas
  • Maria Franzmann
  • Obel, Niels
  • Lebech, Anne-Mette
  • Jesper Bonde

Background: Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. Methods: From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Results: Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)). Conclusions: This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.

Original languageEnglish
Article number740
JournalBMC Infectious Diseases
Volume19
Number of pages10
ISSN1471-2334
DOIs
Publication statusPublished - 2019

    Research areas

  • Cervical cancer, High-risk HPV, HPV genotype distribution, HPV persistence, Immunodeficiency, Women living with HIV

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