Prevalence and risk factors for High-Risk Human Papillomavirus hrHPV infection among HIV-infected and Uninfected Rwandan women: implications for hrHPV-based screening in RwandaReport as inadecuate




Prevalence and risk factors for High-Risk Human Papillomavirus hrHPV infection among HIV-infected and Uninfected Rwandan women: implications for hrHPV-based screening in Rwanda - Download this document for free, or read online. Document in PDF available to download.

Infectious Agents and Cancer

, 9:40

First Online: 08 December 2014Received: 14 August 2014Accepted: 05 November 2014DOI: 10.1186-1750-9378-9-40

Cite this article as: Sinayobye, J

, Sklar, M., Hoover, D.R. et al. Infect Agents Cancer 2014 9: 40. doi:10.1186-1750-9378-9-40

Abstract

BackgroundNew World Health Organization guidelines recommend high-risk human papillomavirus hrHPV screen-and-treat strategies for cervical cancer prevention. We describe risk of, and risk factors for, testing hrHPV positive in a pilot study of hrHPV screen-and-treat conducted in Rwanda.

MethodsA total of 2,964 women, 1,289 HIV-infected HIV + and 1,675 HIV-uninfected HIV -, aged 30-60 years and living in Rwanda were enrolled in 2010. Cervical specimens were collected and tested by careHPV, a DNA test for a pool of 14 hrHPV types. Prevalence with binomial 95% confidence intervals 95% CI and determinants of testing hrHPV positive were calculated.

ResultshrHPV prevalence was higher in HIV + 31.8%, 95% CI = 29.2-34.4% than HIV - women 8.2%, 95% CI = 6.7-9.8%; P < 0.0001. Among HIV + women, there was a significant trend ptrend <0.001 of higher hrHPV prevalence with lower CD4 cell count, with the highest hrHPV prevalence among those with <200 CD4 cell counts 45.5%, 95% CI = 34.8-56.4%. In multivariate analysis of HIV + women, testing hrHPV positive was positively associated CD4 count of <200 cells-μL, history of 3 or more sexual partners, and history of using hormonal contraception, and negatively associated with older age. In HIV - women, testing hrHPV positive was negatively associated only with older age groups of 45-49 and 50-60 years and surprisingly was not associated with lifetime number of sexual partners.

ConclusionhrHPV prevalence is high in HIV +, especially in women with the lowest CD4 cell counts, which may have implications for utilizing hrHPV-based screening strategies such as screen-and-treat in these high-risk subgroups.

KeywordsHPV HIV Cervical cancer Screening Electronic supplementary materialThe online version of this article doi:10.1186-1750-9378-9-40 contains supplementary material, which is available to authorized users.

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Author: Jean d’Amour Sinayobye - Marc Sklar - Donald R Hoover - Qiuhu Shi - Jean Claude Dusingize - Mardge Cohen - Eugene Muti

Source: https://link.springer.com/







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