HPV genotyping in biopsies of HSIL and invasive cervical cancers in women living with HIV: A cohort- and a nested -case control study. Issue 50 (28th November 2022)

• Record Type: Journal Article
• Authors: Gilles, Christine; Rozenberg, Serge; Buxant, Frederic; Manigart, Yannick; de Wind, Roland; Houte, Katherina Vanden; Vandenbroeck, Davy; Delforge, Marc; Konopnicki, Deborah
• Is Part Of: Vaccine. Volume 40:Issue 50(2022)
• Page Start: 7230
• Page End: 7237
• Publication Date: 2022-11-28
• Subjects: HIV -- Human Papillomavirus -- High-Grade Squamous Intraepithelial Lesions -- Uterine cervical neoplasm; Vaccines -- Periodicals; 615.372
• DOI: 10.1016/j.vaccine.2022.10.029
• Languages: English
• ISSNs: 0264-410X

Abstract

Abstract: Objective: To characterize HPV genotype distribution in HSIL and ICC- biopsies, of WLWH, in Europe, as compared to HIV-negative women. Design: Cohort- and nested -case control study. Method: We characterized HPV genotype distribution by performing PCR on HSIL and ICC biopsies from WLWH (n = 170); 85 cases were compared to 85 HIV-negative matched controls. The proportion of patients that might be protected by HPV vaccines was estimated. Results: Among WLWH (median age 36 years-old, median duration of HIV infection 70, 5 months, 79% under cART): the most frequently detected HPV were HPV16 (30%), HPV35 (16%), HPV58 (14, 7%), HPV31 (13, 5%), and HPV52 (11, 7%). HPV16 was less frequently found in WLWH, originating from Central Africa (20, 5%) compared to other African regions (35, 5%) ( p = 0, 05) or world regions (38, 8%) ( p = 0, 007). Multiple versus single high-risk HPV infections were associated with younger age (≤35 years)(odds ratio (OR) 2, 65 (95%IC: 1, 3–5, 2, p = 0, 002), lymphocyte CD4 count < 350 cells / µL (OR 2, 7 (95%IC: 2–8, 5; p = 0, 005), use of cART for < 18 month OR 2, 2 (95%IC: 1, 1–4, 5), p = 0, 04) or a cumulative time with undetectable HIV viral load of less than 12 months (OR 4, 2 (95%IC: 2–8.5, p = 0, 001). HPV 31, 33 and 35 were more frequently detected in samples from WLWH than in HIV-negative controls ( p < 0, 05). The 9-valent vaccine would increase HPV protection, in HIV-positive and negative women ( p < 0, 001). Conclusion: WLWH are more frequently infected with high-risk HPV other than 16 and 18 than HIV-negative ones. The use of 9-valent vaccine may prevent HSIL or ICC in up to 85% of the women. Adding HPV 35 to the HPV vaccine panel, might improve vaccine effectiveness in WLWH.