Human Papillomavirus Typing in HIV-Positive Women

[摘要] Objective:Human papillomavirus (HPV) is the major cause of cervical carcinoma and cervical intraepithelial neoplasia worldwide. Certain HPV types have a strong association with and probably a causative role in thepathogenesis of premalignant cervical lesions. Epidemiologic studies in women infected by the human immunodeficiencyvirus (HIV) have shown an increased incidence of squamous intraepithelial lesions (SILs), whichwere predominantlyhigh-grade. Six to 30 per cent of women diagnosed with atypical squamous cells of undeterminedsignificance (ASCUS) on a Papanicolaou (Pap) smear harbor SIL in normal screening populations. This study wasundertaken to determine the presence of low- and high-risk HPV types in women infected by HIV and to correlatethe results to those of the Pap smear.Study design:HPV DNA typing (low- and high-risk) by Digene™ (Digene Corporation, Gathesburg, MD) hybrid capture methodology was performed on cervical swabs from 209 HIV-positive women. The results of HPV typingwere correlated with those of the Pap smear in a retrospective analysis.Results:One hundred and one women (48%) tested positive for HPV subtypes by DNA typing by the hybrid capture method. Of these, 64 patients (63%) had Pap smears whichwere read as being normal, having benign cellularchanges, or having ASCUS (favor reactive process). Of these, 19 patients tested positive for both high-risk andlow-risk subtypes, 32 patients tested positive only for high-risk subtypes, and 13 patients tested positive only forlow-risk subtypes.Conclusion:HPV subtyping identifies a significant group of HIV-positive women who are at risk for developing cervical intraepithelial neoplasia, although they may not show significant abnormalities on their Pap smears.

[学科分类] 妇产科学