for the HPV and HIV Study Group. Human papillomavirus types among women infected with HIV: a meta-analysis

International Agency for Research on Cancer, Lyon, France.
AIDS (Impact Factor: 5.55). 12/2006; 20(18):2337-44. DOI: 10.1097/01.aids.0000253361.63578.14
Source: PubMed


HIV-positive women have a high prevalence of human papillomavirus (HPV) infection and are infected with a broader range of HPV types than HIV-negative women. It is not known to what extent these different types are associated with high-grade squamous intraepithelial lesions (HSIL) and cancer.
Meta-analysis of HPV type-specific prevalence among HIV-positive women, stratified by geographical region and by cervical cytology: normal, atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL) or HSIL.
In 20 studies, 5578 HIV-positive women were identified, largely from North America but also Africa, Asia, Europe and South/Central America. For 3230 with no cytological abnormalities, prevalence was 36.3% for any HPV and 11.9% for multiple HPV types. The six most common high-risk HPV types were 16 (4.5%), 58 (3.6%), 18 (3.1%), 52 (2.8%), 31 (2.0%) and 33 (2.0%). HPV16 was also the most common type in 2053 HIV-positive women with ASCUS/LSIL and 295 with HSIL. Those with HSIL were significantly less likely to be infected with HPV16 (odds ratio, 0.6; 95% confidence interval, 0.4-0.7) than the general female population with HSIL. In contrast, HIV-positive women with HSIL were significantly more likely to be infected with HPV types 11, 18, 33, 51, 52, 53, 58 and 61, and with multiple HPV types.
The proportion of HIV-positive women with HPV16 rose with increasing severity of cervical lesions. Nevertheless, HPV16 remained underrepresented in HIV-positive women with HSIL, who showed a higher proportion of other HPV types and multiple types compared with the general female population with HSIL.

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    • "This analysis is part of a broad effort to summarize all prevalence and incidence estimates for HPV infection, as well as cytological and histological cervical abnormalities in HIV-positive women in order to populate mathematical models. Based on search strategies used in previous studies [20], [21], we systematically reviewed PubMed, OVID Medline, Embase, and Global Health database using the following combined keywords (HIV OR human immunodeficiency virus) AND (HPV OR human papilloma virus OR human papillomavirus). The query yielded 2,934 records, of which 1,793 remained after the removal of duplicates. "
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    ABSTRACT: Research endeavours require the collaborative effort of an increasing number of individuals. International scientific collaborations are particularly important for HIV and HPV co-infection studies, since the burden of disease is rising in developing countries, but most experts and research funds are found in developed countries, where the prevalence of HIV is low. The objective of our study was to investigate patterns of international scientific collaboration in HIV and HPV research using social network analysis. Through a systematic review of the literature, we obtained epidemiological data, as well as data on countries and authors involved in co-infection studies. The collaboration network was analysed in respect to the following: centrality, density, modularity, connected components, distance, clustering and spectral clustering. We observed that for many low- and middle-income countries there were no epidemiological estimates of HPV infection of the cervix among HIV-infected individuals. Most studies found only involved researchers from the same country (64%). Studies derived from international collaborations including high-income countries and either low- or middle-income countries had on average three times larger sample sizes than those including only high-income countries or low-income countries. The high global clustering coefficient (0.9) coupled with a short average distance between researchers (4.34) suggests a "small-world phenomenon." Researchers from high-income countries seem to have higher degree centrality and tend to cluster together in densely connected communities. We found a large well-connected community, which encompasses 70% of researchers, and 49 other small isolated communities. Our findings suggest that in the field of HIV and HPV, there seems to be both room and incentives for researchers to engage in collaborations between countries of different income-level. Through international collaboration resources available to researchers in high-income countries can be efficiently used to enroll more participants in low- and middle-income countries.
    PLoS ONE 03/2014; 9(3):e93376. DOI:10.1371/journal.pone.0093376 · 3.23 Impact Factor
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    • "used for HPV detection and different methods used for estimating HPV type - specific prevalence ( Bosch et al . , 2008 ; Giuliano et al . , 2008 ) . The adjusted global prevalence of HPV infection was 10 . 4% ( Burchell et al . , 2006 ) . The overall HPV - DNA prevalence in invasive cervical cancer is 96% , based on pooled analysis of 12 studies ( Clifford et al . , 2006b ) . The prevalence of HPV types that cause cervical cancer are ; HPV - 16 ( 53 . 5% ) , - 18 ( 17 . 2% ) , - 45 ( 6 . 7% ) , - 31 ( 2 . 9% ) , - 33 ( 2 . 6% ) , and other high - risk types ; - 52 , - 58 , - 35 , - 59 , - 56 , - 39 , - 51 , - 73 , - 68 and - 66 ( 15 - 20% ) ( Clifford et al . , 2006a ) ."
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    ABSTRACT: Background: Human papillomavirus is a well-established cause of the development of a variety of epithelial lesions in the cervix. However, as yet, incorporation of HPV testing into cervical cancer screening either as an adjunct or stand alone test is limited due to its cost. We therefore here ascertained the presence and type specificity of human papilloma virus (HPV) DNA in routine cervical scrapings. Materials and methods: Cervical scrapings were collected from women attending clinics for routine Pap smear screening. HPV-DNA was detected by PCR using MY09/11 and GP5+/GP6+ primer sets and genotyping was accomplished by cycle-sequencing. Results: A total of 635 women were recruited into the study with mean ± SD age of 43 ± 10.5 years. Of these 92.6% (588/635) were reported as within normal limits (WNL) on cytology. The presence of HPV infection detected by nested MY/GP+-PCR was 4.4% (28/635). The overall prevalence of high-risk HPV (HR-HPV) in abnormal Pap smears was 53.8% (7/13). HPVs were also seen in 3.1% (18/588) of smears reported as WNL by cytology and 5.9% (2/34) in smears unsatisfactory for evaluation. Conclusions: The overall percentage of HPV positivity in routine cervical screening samples is comparable with abnormal findings in cytology. Conventional Pap smear 'missed' a few samples. Since HPV testing is expensive, our results may provide valuable information for strategising implementation of effective cervical cancer screening in a country with limited resources like Malaysia. If Pap smear coverage could be improved, HPV testing could be used as an adjunct method on cases with ambiguous diagnoses.
    Asian Pacific journal of cancer prevention: APJCP 03/2014; 15(5):2245-9. DOI:10.7314/APJCP.2014.15.5.2245 · 2.51 Impact Factor
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    • "Clifford and colleagues showed in their meta-analysis involving 20 publications that apart from viral types, immune-suppression of HIV infection significantly increased the risk for HPV infection and invasive cancer [38]. In addition, the reported more frequent multiple HPV types in HIV-positive women was consistent with previous reports [8-10], and may be attributable to the common mode of transmission of HPV and HIV; persistence of HPV as a result of the inability to clear HPV infections; as well as reactivation of latent HPV infections [38]. "
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    ABSTRACT: The expected reduction in cervical cancer incidence as result of increased access to antiretroviral therapy is yet to be seen. In this study we investigated the effect of HIV infection and treatment on high-risk (hr) human papilloma virus (HPV) prevalence and distribution. Cervical cells from 515 (220 HIV positive and 295 HIV negative) women, recruited during community cervical cancer screening programme in states of Ogun and Lagos and at the cervical cancer screen clinic, Nigerian Institute of Medical Research Lagos were evaluated for the presence of 13 hr HPV genotypes by polymerase chain reaction based assay. The prevalence of high-risk HPV was 19.6% in the studied population. HPV 16 (3.9%), 35(3.5%), 58(3.3%) and 31(3.3%) were the most common hr HPV infections detected. We observed that the prevalence of hr HPV was higher in HIV positives (24.5%) than 15.9% in HIV negative women (OR = 1.7; 95% CI 1.1-2.7). A multivariate logistic regression analysis showed a lower hr HPV prevalence in HIV positive women on antiretroviral drugs (OR = 0.4; 95% CI: 0.3-0.5) and with CD4 count of 500 and above (OR = 0.7; 95% CI 0.5-0.8). A higher prevalence of hr HPV was also noted in HIV positive women with CD4 count < 200 cells/mm3 (OR = 2.4; 95% CI: 1.7-5.9). HPV 16, 35, 58 and 31genotypes were the most common hr HPV infection in our study group, which could be regarded as high risk general population sample; with higher prevalence of HPV 16 and 35 in HIV positive than in HIV negative women. The use of antiretroviral drugs was found to be associated with a lower prevalence of hr HPV infection, compared to those not on treatment. This study raises important issues that should be further investigated to enable the development of robust cervical cancer prevention and control strategies for women in our setting.
    Virology Journal 01/2014; 11(1):5. DOI:10.1186/1743-422X-11-5 · 2.18 Impact Factor
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