Multiple High Risk and Non-Vaccine HPV Types in Ugandan Women Living with HIV on Long-Term Antiretroviral Therapy

2021 ◽  
Author(s):  
Carol Nakisige ◽  
Scott V. Adams ◽  
Constance Namirembe ◽  
Lazarus Okoche ◽  
James Ferrenberg ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
High Risk ◽  
Women Living With Hiv ◽  
Hpv Types ◽  
Living With Hiv

scholarly journals Type-specific persistence, clearance and incidence of high-risk HPV among screen-positive Rwandan women living with HIV

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Gad Murenzi ◽  
Patrick Tuyisenge ◽  
Faustin Kanyabwisha ◽  
Athanase Munyaneza ◽  
Benjamin Muhoza ◽  
...  
Keyword(s):  
High Risk ◽  
Significant Proportion ◽  
Women Living With Hiv ◽  
Screening Study ◽  
Hpv Types ◽  
The Mean ◽  
Nested Analysis ◽  
High Risk Hpv ◽  
Living With Hiv ◽  
Hrhpv Type

Abstract Background Persistent infection with high-risk human papillomavirus (hrHPV) is a critical step in cervical carcinogenesis. We report on type-specific hrHPV persistence, clearance and incidence among screen-positive Rwandan women living with HIV (WLWH). Methods This was a nested analysis from a large cervical cancer screening study of ~ 5000 Rwandan WLWH. Women who tested positive for hrHPV and/or visual inspection with acetic acid were referred to colposcopy. For a subset of women (n = 298) who were ≥ 6 months delayed in receiving colposcopy, we tested their screening and colposcopy visit specimens using the AmpFire HPV genotyping assay that tests 14 hrHPV types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) individually. Results The mean, median (interquartile range [IQR]) and range of time between the screening and colposcopy visits were 644, 650 (490–820.5) and 197–1161 days, respectively. Mean, median (IQR) and range of age at the screening visit were 38, 37 (34–43) and 30–54 years, respectively. Two-hundred eighty-three (95.0%) had CD4 count (cells per mm3) data available at baseline with mean, median (IQR) and range of 592, 513 (346–717) and 0–7290, respectively. Two-hundred thirty-five WLWH were positive for at least one hrHPV type at the screening visit, of whom 50.2% had at least one HPV type-specific infection persist; 37.2% of all HPV infections detected at the screening visit persisted. Compared to all other HPV types in aggregate, HPV16 (vs. non-HPV16 types) (47.7%, p = 0.03) and HPV33 (vs. non-HPV33 types) (56.7%, p = 0.03) were significantly more likely, and HPV39 (vs. non-HPV39 types) (6.7%, p = 0.01), HPV51 (vs. non-HPV51 types) (15.6%, p < 0.01), and HPV66 (vs. non-HPV66 types (17.9%, p = 0.04) were significantly less likely, to persist. Lower CD4 counts were associated with having any persistent hrHPV infection (ptrend = 0.04) and multiple persistent hrHPV infections (ptrend = 0.04). Conclusion There is a significant proportion of WLWH with persistent hrHPV infection, emphasizing the need to vaccinate them against HPV prior to becoming sexually active.

scholarly journals Long-term effects of unintended pregnancy on antiretroviral therapy outcomes among South African women living with HIV

AIDS ◽  
2019 ◽  
Vol 33 (5) ◽  
pp. 885-893 ◽  
Author(s):  
Kirsty Brittain ◽  
Tamsin K. Phillips ◽  
Allison Zerbe ◽  
Elaine J. Abrams ◽  
Landon Myer
Keyword(s):  
Antiretroviral Therapy ◽  
South African ◽  
Unintended Pregnancy ◽  
African Women ◽  
Long Term Effects ◽  
Therapy Outcomes ◽  
Women Living With Hiv ◽  
South African Women ◽  
Living With Hiv

scholarly journals High‐risk HPV positivity is a long‐term risk factor for recurrence after cervical excision procedure in women living with HIV

2021 ◽  
Author(s):  
Alberto Agarossi ◽  
Giovanni Delli Carpini ◽  
Francesco Sopracordevole ◽  
Matteo Serri ◽  
Luca Giannella ◽  
...  
Keyword(s):  
Risk Factor ◽  
High Risk ◽  
Women Living With Hiv ◽  
High Risk Hpv ◽  
Living With Hiv ◽  
Risk Factor For Recurrence

Social Vulnerability among Foreign-Born Pregnant Women and Maternal Virologic Control of HIV

2020 ◽  
Author(s):  
Ashish Premkumar ◽  
Lynn M. Yee ◽  
Lia Benes ◽  
Emily S. Miller
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Median Time ◽  
Social Vulnerability ◽  
Viral Suppression ◽  
Foreign Born ◽  
Women Living With Hiv ◽  
Virologic Control ◽  
Clinical Records ◽  
Living With Hiv

Objective The aim of this study was to assess whether social vulnerability among foreign-born pregnant women living with HIV is associated with maternal viremia during pregnancy. Study Design This retrospective cohort study included all foreign-born pregnant women living with HIV who received prenatal care in a multidisciplinary prenatal clinic between 2009 and 2018. A licensed clinical social worker evaluated all women and kept detailed clinical records on immigration status and social support. Social vulnerability was defined as both living in the United States for less than 5 years and reporting no family or friends for support. The primary outcome was evidence of viral non-suppression after achievement of initial suppression. Secondary outcomes were the proportion of women who required > 12 weeks after starting antiretroviral therapy to achieve viral suppression, median time to first viral suppression (in weeks) after initiation of antiretroviral therapy, and the proportion who missed ≥ 5 doses of antiretroviral therapy. Bivariable analyses were performed. Results A total of 111 foreign-born women were eligible for analysis, of whom 25 (23%) were classified as socially vulnerable. Social and clinical characteristics of women diverged by social vulnerability categorization but no differences reached statistical significance. On bivariable analysis, socially-vulnerable women were at increased risk for needing > 12 weeks to achieve viral suppression (relative risk: 1.78, 95% confidence interval: 1.18–2.67), though there was no association with missing ≥ 5 doses of antiretroviral therapy or median time to viral suppression after initiation of antiretroviral therapy. Conclusion Among foreign-born, pregnant women living with HIV, markers of virologic control during pregnancy were noted to be worse among socially-vulnerable women. Insofar as maternal viremia is the predominant driver of perinatal transmission, closer clinical surveillance and support may be indicated in this population. Key Points

scholarly journals Two-years persistence of anal high-risk HPV infections in women living with HIV, results from the EVVA study

2018 ◽  
Vol 5 ◽  
pp. S12
Author(s):  
Alexandra de Pokomandy ◽  
Alexandra de Pokomandy ◽  
Bernard Lessard ◽  
Marie-Hélène Mayrand ◽  
Louise Charest ◽  
...  
Keyword(s):  
High Risk ◽  
Women Living With Hiv ◽  
High Risk Hpv ◽  
Living With Hiv
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