Human papillomavirus type-specific risk of cervical cancer in a population with high human immunodeficiency virus prevalence: case-control study
Menée au Mozambique, cette étude (221 cas et 203 témoins) évalue l'association entre une infection par le papillomavirus humain de types 16 et 18 et le risque de cancer du col de l'utérus parmi une population déjà infectée par le VIH
There is limited data on Human papillomavirus (HPV) type-specific cervical cancer risk among Human Immunodeficiency virus (HIV) positive women. Previous studies have suggested that HPV 16 would be relatively less important as a causative agent among HIV positive compared to HIV negative women. This study investigates HPV type-specific cervical cancer risk in an HIV endemic population. At the Central Hospital, Maputo, Mozambique 221 cervical cancer cases and 203 hospital-based controls were consecutively enrolled. HPV typing from cervical samples, HIV testing and recording of socio-demographic factors was performed. Logistic regression modeling was used to assess HPV type-specific risk and effect modification between HIV and HPV infection. Infection with HPV 16, 18 and "high-risk non-HPV 16/18 types" (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59) were associated with cervical cancer in both crude and adjusted analyses. HPV 16 and 18 were the most common types detected in cancer biopsies both among HIV negative and positive women. There was no significant evidence of effect modification between any HPV type and HIV infection, and there were no significant differences in the HPV type-specific prevalence when cervical cancers among HIV positive and HIV negative women were compared. Within the limitations of the study, the relative importance of different HPV types in cervical carcinogenesis appears not to be greatly modified by HIV infection, suggesting that HPV vaccines might not need to be type-specifically modified to fit HIV endemic populations.
http://vir.sgmjournals.org/content/early/2011/09/01/vir.0.034298-0.abstract