Epstein-Barr Virus, High-Risk Human Papillomavirus and Abnormal Cervical Cytology in a Prospective Cohort of African Female Sex Workers. Issue 10 (October 2018)

• Record Type: Journal Article
• Authors: Cameron, Jennifer E.; Rositch, Anne F.; Vielot, Nadja A.; Mugo, Nelly R.; Kwatampora, Jessie K.L.; Waweru, Wairimu; Gilliland, Aubrey E.; Hagensee, Michael E.; Smith, Jennifer S.
• Is Part Of: Sexually transmitted diseases. Volume 45:Issue 10(2018)
• Publication Date: 2018-10
• Subjects: Sexually transmitted diseases -- Periodicals; Sexual health -- Periodicals; 616.951005
• DOI: 10.1097/OLQ.0000000000000857
• Languages: English
• ISSNs: 0148-5717

Abstract

Abstract : Background: High-oncogenic-risk human papillomavirus (hrHPV) is necessary, although insufficient, to promote cervical cancer. Like HPV, Epstein-Barr virus (EBV) is a common pathogen with the capacity to promote epithelial neoplasms. We examined the association between cervical EBV, hrHPV, and cytology in female sex workers in Nairobi, Kenya. Methods: Women (n = 332) with known cervical cytology and hrHPV mRNA results were evaluated for cervical EBV DNA by conventional polymerase chain reaction. Prevalence ratios (PRs) were calculated to assess the relationships between EBV, hrHPV, and cervical cytology. Prospective analyses used risk ratios and time-to-event analyses to determine the association of EBV with hrHPV clearance and with abnormal cytology outcomes. Results: Baseline prevalence of hrHPV and EBV was 29% and 19%, respectively. Higher EBV prevalence was found among women with older age, HIV, hrHPV, abnormal cytology, Mycoplasma genitalium infection, smoking habits, younger age at sexual debut, and less frequent condom use. At baseline, women with EBV had a higher prevalence of hrHPV infection than did EBV-negative women (52% vs. 24%; HIV-adjusted PR [95% confidence interval], 1.8 [1.3–2.6]). Epstein-Barr virus–positive women had a higher prevalence than did EBV-negative women of high-grade precancer (15% vs. 2%) and abnormal cytology (37% vs. 15%), although HIV- and hrHPV-adjusted associations were not significant (high-grade precancer: PR, 2.0 [0.7–5.9]; abnormal cytology: PR, 1.4 [0.9–2.2]). In prospective analyses, a marginal association was observed between baseline EBV detection and delayed hrHPV clearance. Conclusions: Our data support a possible role for EBV as a high-risk marker or cofactor for HPV-mediated cervical cancer development. Abstract : Women with high-risk human papillomavirus and Epstein-Barr virus had a higher prevalence of cervical abnormalities compared with women with only high-risk human papillomavirus, indicating a possible role for Epstein-Barr virus as a cofactor of cervical precancer.Supplemental digital content is available in the text.