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Persistence of Non-Vaccine Oncogenic HPV Serotypes in Quadrivalent HPV2 Vaccinated Women Living with HIV McClymont, Elisabeth; Coutlée, François; Lee, Marette; Albert, Arianne; Raboud, Janet; Walmsley, Sharon; Lipsky, Nancy; Loutfy, Mona; Trottier, Sylvie; Smaill, Fiona; Klein, Marina B.; Yudin, Mark H.; Harris, Marianne; Wobeser, Wendy; Bitnun, Ari; Samson, Lindy; Money, Deborah M.

Abstract

Objective: To describe prevalent and persistent oncogenic HPV types detected in women living with HIV (WLWH) in Canada, including in women with cervical dyskaryosis, and to determine predictors of type-specific HPV persistence. Methods: 252 women were eligible for this sub-analysis of a prospective vaccine immunogenicity cohort study (2 HPV DNA results, ≥1 cervical cytology result pre60 vaccination). Demographic and clinical data were collected alongside cervical samples for cytology and HPV DNA typing between 2008-2015. Results: Pre-vaccination, HPV16 and HPV52 were the most prevalent oncogenic HPV types. Forty-five percent of participants were infected with ≥1 oncogenic HPV type and one-third of participants had a persistent oncogenic infection. HPV16, 45, and 52 were the most frequently persistent types. Seventeen percent of women had persistent infections with oncogenic HPV types not within currently available vaccines (HPV35/39/51/56/59/68/82). Lower CD4 count significantly predicted HPV persistence (p=0.024). Cervical cytology was 82.9% normal, 2.4% atypical squamous cells of undetermined significance, 11.5% low-grade squamous intraepithelial lesions, and 2.8% high-grade squamous intraepithelial lesions. Conclusion: Unvaccinated WLWH were infected with a wide range of oncogenic HPV types. Our findings highlight the importance of optimal HIV treatment and continued cervical cancer screening as key steps towards global elimination of cervical cancer.

Item Metadata

Title
Persistence of Non-Vaccine Oncogenic HPV Serotypes in Quadrivalent HPV2 Vaccinated Women Living with HIV
Creator
McClymont, Elisabeth; Coutlée, François; Lee, Marette; Albert, Arianne; Raboud, Janet; Walmsley, Sharon; Lipsky, Nancy; Loutfy, Mona; Trottier, Sylvie; Smaill, Fiona; Klein, Marina B.; Yudin, Mark H.; Harris, Marianne; Wobeser, Wendy; Bitnun, Ari; Samson, Lindy; Money, Deborah M.
Contributor
British Columbia Centre for Excellence in HIV/AIDS; Women's Health Research Institute (British Columbia)
Publisher
Wolters Kluwer
Date Issued
2020-03-01
Description
Objective: To describe prevalent and persistent oncogenic HPV types detected in women living with HIV (WLWH) in Canada, including in women with cervical dyskaryosis, and to determine predictors of type-specific HPV persistence. Methods: 252 women were eligible for this sub-analysis of a prospective vaccine immunogenicity cohort study (2 HPV DNA results, ≥1 cervical cytology result pre60 vaccination). Demographic and clinical data were collected alongside cervical samples for cytology and HPV DNA typing between 2008-2015. Results: Pre-vaccination, HPV16 and HPV52 were the most prevalent oncogenic HPV types. Forty-five percent of participants were infected with ≥1 oncogenic HPV type and one-third of participants had a persistent oncogenic infection. HPV16, 45, and 52 were the most frequently persistent types. Seventeen percent of women had persistent infections with oncogenic HPV types not within currently available vaccines (HPV35/39/51/56/59/68/82). Lower CD4 count significantly predicted HPV persistence (p=0.024). Cervical cytology was 82.9% normal, 2.4% atypical squamous cells of undetermined significance, 11.5% low-grade squamous intraepithelial lesions, and 2.8% high-grade squamous intraepithelial lesions. Conclusion: Unvaccinated WLWH were infected with a wide range of oncogenic HPV types. Our findings highlight the importance of optimal HIV treatment and continued cervical cancer screening as key steps towards global elimination of cervical cancer.
Subject
HPV; HPV vaccine; HIV; Cervical cancer; Women
Geographic Location
Canada
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2021-03-01
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial 4.0 International
DOI
10.14288/1.0394539
URI
http://hdl.handle.net/2429/76196
Affiliation
Medicine, Faculty of; Non UBC; Obstetrics and Gynaecology, Department of; Other UBC
Citation
McClymont E, Coutlée F, Lee M, Albert A, Raboud J, Walmsley S, Lipsky N, Loutfy M, Trottier S, Smaill F, Klein MB, Yudin MH, Harris M, Wobeser W, Bitnun A, Samson L, Money D; CTN 236 HPV in HIV Study Team. Brief Report: Persistence of Non-Vaccine Oncogenic HPV Genotypes in Quadrivalent HPV-Vaccinated Women Living With HIV. J Acquir Immune Defic Syndr. 2020 Mar 1;83(3):230-234
Publisher DOI
10.1097/QAI.0000000000002258
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher; Graduate
Rights URI
http://creativecommons.org/licenses/by-nc/4.0/
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Attribution-NonCommercial 4.0 International