Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
Vol. 111, No. 2, 2016, pp. 120-127
Bioline Code: oc16016
Full paper language: English
Document type: Research Article
Document available free of charge
Memórias do Instituto Oswaldo Cruz, Vol. 111, No. 2, 2016, pp. 120-127
© Copyright 2016 - Memórias do Instituto Oswaldo Cruz
Bonafide, type-specific human papillomavirus persistence among HIV-positive pregnant women: predictive value for cytological abnormalities, a longitudinal cohort study|
Meyrelles, Angela R.I.; Siqueira, Juliana D.; Santos, Pâmela P. dos; Hofer, Cristina B.; Luiz, Ronir R.; Seuánez, Héctor N.; Almeida, Gutemberg; Soares, Marcelo A.; Soares, Esmeralda A. & Machado, Elizabeth S.
This study investigated the rate of human papillomavirus (HPV) persistence, associated risk factors, and predictors
of cytological alteration outcomes in a cohort of human immunodeficiency virus-infected pregnant women
over an 18-month period. HPV was typed through L1 gene sequencing in cervical smears collected during gestation
and at 12 months after delivery. Outcomes were defined as nonpersistence (clearance of the HPV in the 2nd sample),
re-infection (detection of different types of HPV in the 2 samples), and type-specific HPV persistence (the same HPV
type found in both samples). An unfavourable cytological outcome was considered when the second exam showed
progression to squamous intraepithelial lesion or high squamous intraepithelial lesion. Ninety patients were studied.
HPV DNA persistence occurred in 50% of the cases composed of type-specific persistence (30%) or re-infection
(20%). A low CD4+ T-cell count at entry was a risk factor for type-specific, re-infection, or HPV DNA persistence.
The odds ratio (OR) was almost three times higher in the type-specific group when compared with the re-infection
group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that bonafide (type-specific) HPV persistence
is a stronger predictor for the development of cytological abnormalities, highlighting the need for HPV typing
as opposed to HPV DNA testing in the clinical setting.
pregnancy; persistence; HPV; HIV
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