Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark: The SHADE

Kristina Thorsteinsson; Steen Ladelund; Merete Storgaard; Terese L. Katzenstein; Isik Somuncu Johansen; Gitte Pedersen; Frederikke Falkencrone Rönsholt; Lars Nørregård Nielsen; Lisbeth Nilas; Maria Franzmann; Niels Obel; Anne Mette Lebech; Jesper Bonde

doi:10.1186/s12879-019-4377-5

Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark: The SHADE

Kristina Thorsteinsson^*, Steen Ladelund, Merete Storgaard, Terese L. Katzenstein, Isik Somuncu Johansen, Gitte Pedersen, Frederikke Falkencrone Rönsholt, Lars Nørregård Nielsen, Lisbeth Nilas, Maria Franzmann, Niels Obel, Anne Mette Lebech, Jesper Bonde

^*Corresponding author for this work

Department of Clinical Medicine

2 Citations (Scopus)

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Abstract

Background: Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. Methods: From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Results: Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)). Conclusions: This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.

Original language	English
Article number	740
Journal	BMC Infectious Diseases
Volume	19
Number of pages	10
ISSN	1471-2334
DOIs	https://doi.org/10.1186/s12879-019-4377-5
Publication status	Published - 2019

Keywords

Cervical cancer
High-risk HPV
HPV genotype distribution
HPV persistence
Immunodeficiency
Women living with HIV

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Thorsteinsson, K., Ladelund, S., Storgaard, M., Katzenstein, T. L., Johansen, I. S., Pedersen, G., Rönsholt, F. F., Nielsen, L. N., Nilas, L., Franzmann, M., Obel, N., Lebech, A. M., & Bonde, J. (2019). Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark: The SHADE. BMC Infectious Diseases, 19, [740]. https://doi.org/10.1186/s12879-019-4377-5

@article{160d6c0addbd422bab04400d5ac781be,

title = "Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark: The SHADE",

abstract = "Background: Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. Methods: From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Results: Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)). Conclusions: This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.",

keywords = "Cervical cancer, High-risk HPV, HPV genotype distribution, HPV persistence, Immunodeficiency, Women living with HIV",

author = "Kristina Thorsteinsson and Steen Ladelund and Merete Storgaard and Katzenstein, {Terese L.} and Johansen, {Isik Somuncu} and Gitte Pedersen and R{\"o}nsholt, {Frederikke Falkencrone} and Nielsen, {Lars N{\o}rreg{\aa}rd} and Lisbeth Nilas and Maria Franzmann and Niels Obel and Lebech, {Anne Mette} and Jesper Bonde",

year = "2019",

doi = "10.1186/s12879-019-4377-5",

language = "English",

volume = "19",

journal = "B M C Infectious Diseases",

issn = "1471-2334",

publisher = "BioMed Central Ltd.",

}

TY - JOUR

T1 - Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark

T2 - The SHADE

AU - Thorsteinsson, Kristina

AU - Ladelund, Steen

AU - Storgaard, Merete

AU - Katzenstein, Terese L.

AU - Johansen, Isik Somuncu

AU - Pedersen, Gitte

AU - Rönsholt, Frederikke Falkencrone

AU - Nielsen, Lars Nørregård

AU - Nilas, Lisbeth

AU - Franzmann, Maria

AU - Obel, Niels

AU - Lebech, Anne Mette

AU - Bonde, Jesper

PY - 2019

Y1 - 2019

N2 - Background: Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. Methods: From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Results: Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)). Conclusions: This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.

AB - Background: Women living with HIV (WLWH) have high rates of persistent high-risk human papillomavirus (hrHPV) infections and cervical cancer. We aimed to assess the distribution of hrHPV genotypes, risk factors of type-specific hrHPV persistence, and high-grade squamous intraepithelial lesions or worse (≥HSIL) in WLWH in Denmark. Methods: From the prospective Study on HIV, cervical Abnormalities and infections in women in Denmark (SHADE) we identified WLWH with a positive hrHPV test during the study period; 2011-2014. HIV demographics were retrieved from the Danish HIV Cohort Study and pathology results from the The Danish Pathology Data Bank. Logistic regression was used to identify risk factors associated with persistent hrHPV infection (positivity of the same hrHPV type in two samples one-two years after the first hrHPV positive date) and ≥ HSIL. Results: Of 71 WLWH, 31 (43.7%) had persistent hrHPV infection. Predominant hrHPV genotypes were HPV58, 52, 51, and 35 and most frequently observed persistent genotypes were HPV52, 33 and 31. CD4 < 350 cells/μL predicted genotype-specific hrHPV persistence (adjusted OR 4.36 (95%CI: 1.18-16.04)) and ≥ HSIL was predicted by prior AIDS (adjusted OR 8.55 (95% CI 1.21-60.28)). Conclusions: This prospective cohort study of well-treated WLWH in Denmark found a high rate of persistent hrHPV infections with predominantly non-16/18 hrHPV genotypes. CD4 count < 350 cells/μL predicted hrHPV persistence, while prior AIDS predicted ≥HSIL.

KW - Cervical cancer

KW - High-risk HPV

KW - HPV genotype distribution

KW - HPV persistence

KW - Immunodeficiency

KW - Women living with HIV

U2 - 10.1186/s12879-019-4377-5

DO - 10.1186/s12879-019-4377-5

M3 - Journal article

C2 - 31438877

AN - SCOPUS:85071278831

SN - 1471-2334

VL - 19

JO - B M C Infectious Diseases

JF - B M C Infectious Diseases

M1 - 740

ER -

Persistence of cervical high-risk human papillomavirus in women living with HIV in Denmark: The SHADE

Abstract

Keywords

UN SDGs

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