%0 Journal Article
%T High-risk human papillomavirus infection in HIV-positive African women living in Europe
%A Deborah Konopnicki
%A Yannick Manigart
%A Christine Gilles
%A Patricia Barlow
%J Journal of the International AIDS Society
%D 2013
%I 
%R 10.7448/ias.16.1.18023
%X Introduction: Cervical infection with high-risk human papillomavirus (HRHPV) induces cervical cancer and is present in 14% of women in Europe. We assessed the prevalence and incidence of cervical HRHPV in a cohort of HIV-positive women living in Belgium. Methods: Prospective observational program of screening and follow up of HRHPV cervical infection performed by Hybrid Capture in 825 HIV-positive women between 2002 and 2011. Women without normal cervix at baseline were excluded. Results: The final analysis included 652 women: median age 38 years, African origin (81%), median HIV follow-up (66 months), median CD4 count (426 cells/¦ĚL) and 79% on antiretroviral therapy (cART). At baseline, HRHPV prevalence was 43% and decreased significantly as both age and CD4 cell count increased: highest prevalence (100%) in women <30 years and <200 CD4/¦ĚL and lowest (19%) in women >40 years and >500 CD4/¦ĚL (p<0.0001, multivariate analysis). The relative risk (RR) to carry HRHPV at baseline decreases proportionally by 11% for each 5 years-age increase and by 11% for each 100 CD4 cells/¦ĚL rise (RR=0.89, 95% CI: 0.85-0.93; p<0.0001, Poisson regression for both). During follow-up, incidence rate of HRHPV was 13.4 per 100 women-years. Conclusion: We found a high HRHPV prevalence of 43% and an incidence rate of 13 per 100 women-years in this cohort of HIV-positive women living in Europe and on cART. Women under 40 years-age had the highest prevalence even with CD4 count >350 cells/¦ĚL. The magnitude of HRHPV epidemiology should prompt to evaluate the clinical efficacy of vaccines against HPV in HIV-infected women.
%K HPV
%K HIV
%K prevalence
%K incidence
%K women
%K Europe
%K CD4 cell count
%K cervix
%U http://www.jiasociety.org/index.php/jias/article/view/18023/2840