NYMC Faculty Publications
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
Author Type(s)
Faculty
DOI
10.1186/1750-9378-9-40
Journal Title
Infectious Agents and Cancer
First Page
40
Last Page
40
Document Type
Article
Publication Date
12-2014
Department
Medicine
Disciplines
Medicine and Health Sciences
Abstract
BACKGROUND: New 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.
METHODS: A 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.
RESULTS: hrHPV 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.
CONCLUSION: hrHPV 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.
Recommended Citation
Sinayobye, J. d., Sklar, M., Hoover, D. R., Shi, Q., Dusingize, J. C., Cohen, M., Mutimura, E., Asiimwe-Kateera, B., Castle, P. E., Strickler, H., & Anastos, K. (2014). 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. Infectious Agents and Cancer, 9, 40-40. https://doi.org/10.1186/1750-9378-9-40
