1. Racial differences in human papilloma virus types amongst United States women with HIV and cervical precancer.
- Author
-
Keller MJ, Burk RD, Massad LS, Eltoum IE, Hessol NA, Anastos K, Xie X, Minkoff H, Xue X, Reimers LL, Kuniholm M, DʼSouza G, Colie C, Aouizerat B, Palefsky JM, and Strickler HD
- Subjects
- Adult, Black or African American, Female, Genotyping Techniques, Humans, Longitudinal Studies, Middle Aged, Papanicolaou Test, Papillomaviridae isolation & purification, Papillomavirus Infections complications, Papillomavirus Infections epidemiology, Polymerase Chain Reaction, Precancerous Conditions epidemiology, Prevalence, United States epidemiology, White People, Cervix Uteri pathology, Cervix Uteri virology, Genotype, HIV Infections complications, Papillomaviridae classification, Papillomavirus Infections virology, Precancerous Conditions virology
- Abstract
Objective: Recent studies reported a lower human papillomavirus 16 (HPV16) prevalence in cervical precancer among African American than Caucasian women in the general population. We assessed this relationship in women with HIV., Design: Women living with or at risk for HIV in the Women's Interagency HIV Study were followed semi-annually with Pap tests, colposcopy/histology (if indicated), and collection of cervicovaginal lavage samples for HPV testing by PCR. Racial and ethnic groups were defined using genomic Ancestry Informative Markers (AIMs)., Results: Among 175 cases of cervical intraepithelial neoplasia 3 or worse (CIN-3+), 154 were diagnosed in women with HIV. African American (27%) and Hispanic (37%) cases were significantly less likely than Caucasian (62%) women to test positive for HPV16 (P = 0.01). In multivariate logistic regression models, these associations remained significant for African Americans (odds ratio = 0.13; 95% confidence interval (CI) 0.04-0.44; P = 0.001) but not Hispanics, after controlling for HIV status, CD4 count, history of AIDS, age, smoking, and sexual behavior. Limiting the analysis to women with HIV did not change the findings., Conclusion: HPV16 prevalence is lower in African American compared with Caucasian women with HIV and cervical precancer, independent of immune status. Future studies to determine why these racial differences exist are warranted, and whether there are similar associations between race and invasive cervical cancer in women with HIV. Further, HPV types not covered by quadrivalent and bivalent vaccines may play an especially important role in cervical precancer among HIV-positive African American women, a possible advantage to using nonavalent HPV vaccine in this population. more...
- Published
- 2018
- Full Text
- View/download PDF