Human papillomavirus sequencing reveals its usefulness for the management of HIV‐infected women at risk for developing cervical cancer. Issue 6 (23rd March 2021)

• Record Type: Journal Article
• Authors: Piyathilake, Chandrika J.; Kumar, Ranjit; Crowley, Michael R.; Badiga, Suguna; Burkholder, Greer A.
• Is Part Of: Journal of obstetrics and gynaecology research. Volume 47:Issue 6(2021)
• Page Start: 2185
• Page End: 2195
• Publication Date: 2021-03-23
• Subjects: abnormal cervical cytology -- cervix -- HIV‐infected women -- HPV -- next‐generation sequencing; Gynecology -- Periodicals; Obstetrics -- Periodicals; 618.1005
• DOI: 10.1111/jog.14754
• Languages: English
• ISSNs: 1341-8076

Abstract

Abstract: Aim: Next‐generation sequencing (NGS) is able to describe the composition of human papillomaviruses (HPVs) as percent (%) reads rather than positive/negative results. Therefore, we used this unique approach to assess the prevalence of cervical HPVs of HIV infected (HIV+) in order to understand the determinants of being infected with higher % reads of high risk (HR)‐HPVs and cervical abnormalities of atypical squamous cells of unknown significance or higher (ASCUS+). Methods: Study included 66 women characterized for relevant risk factors/cytology. Receiver‐operating curve curve was used to derive the optimal % read cut point to identify ASCUS+ in relation to any HR‐HPV genotype or other specific HPV genotypes. The determinants of ASCUS+ and HR‐HPVs were tested using logistic regression. Results: Women with >20% reads of any HR‐HPV or >12% any HR‐HPV other than HPV 16/18 were 5.7 and 12.6 times more likely to be diagnosed with ASCUS+, respectively. Lower CD4 count was a significant determinant of >20% reads of HR‐HPV (odds ratio [OR] = 4.1) or >12% any HR‐HPV other than HPV 16/18 (OR = 4.5). Conclusion: We envision that the NGS‐based HPV detection will be more accurate for screening and management of HIV+ at risk for developing cervical cancer (CC). We raise concerns regarding the limitations of 16/18‐based HPV testing for triage and the efficacy of current HPV vaccines for preventing CC in HIV+.