Time trend analysis of cervical high-risk human papillomavirus (HPV) in HIV-infected women in an urban cohort from Rio de Janeiro, Brazil: the rise of non-16/18 HPV

Int J Infect Dis. 2015 Dec:41:17-20. doi: 10.1016/j.ijid.2015.10.017. Epub 2015 Oct 28.

Abstract

Objectives: HIV-infected women are at increased risk of human papillomavirus (HPV) infection. Time trends in annual prevalences of cervical high-risk human papillomavirus (HR-HPV) genotypes among a non-vaccinated, HIV-infected female cohort in urban Brazil were assessed for the period 2006-2012.

Methods: Cervical specimens were collected for HPV genotyping yearly between January 2006 and December 2012 in a cross-sectional analysis of participants aged ≥18 years enrolled in the Women's HIV Cohort at Fiocruz in Rio de Janeiro, Brazil. Age-adjusted generalized estimating equation models with an exchangeable matrix were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for annual HPV positivity (reference year: 2006).

Results: Among the 590 participants, the median age across all study years ranged from 35.5 to 40.0 years. The prevalence of any HR-HPV was ≥53% every year; prevalences of HR-HPV 16, 58, 59, and 68 were ≥24% in at least 1 year. The odds of HPV 16 and 68 decreased in 2012. HPV 58 prevalence followed a U-shape, beginning and ending at >20%. HPV 59 prevalence followed a linear trend, with increased odds in 2012 (OR 16.0, 95% CI 3.8-67.3; Bonferroni-adjusted p-value <0.01).

Conclusions: The prevalences of HR-HPV 58, 59, and 68 were high in this cohort. Given current HR-HPV vaccine coverage and availability, further investigations are needed to optimize vaccine recommendations for this population.

Keywords: Cervical HPV; Epidemiology; HIV; HPV vaccine; High-risk HPV; Women.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brazil / epidemiology
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Genotype
  • HIV Infections / complications*
  • HIV Infections / epidemiology*
  • Humans
  • Middle Aged
  • Odds Ratio
  • Papillomaviridae / genetics
  • Papillomavirus Infections / complications*
  • Papillomavirus Infections / epidemiology*
  • Prevalence
  • Risk Factors
  • Time Factors
  • Urban Population