HPV Genotype Distribution in Cervical Intraepithelial Neoplasia among HIV-Infected Women in Pune, India

Mane, Arati; Nirmalkar, Amit; Risbud, Arun; Vermund, Sten H.; Mehendale, Sanjay; Sahasrabuddhe, Vikrant V.

doi:10.1371/journal.pone.0038731

Cited by 34 publications

(53 citation statements)

References 38 publications

(47 reference statements)

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“…The clearance rates observed in our study was significantly lower than reported in studies (68.3 to 80.7%) among HIV-seronegative women. 4,22–25 However previous studies amongst HIV-seropositive women have reported HPV clearance rates that are comparable 16 , higher 4,8,23,26 and even lower 19 than ours. As reported in earlier studies, we too observed lower clearance rates in women having infection with carcinogenic HPV types especially the alpha-9 species, compared to the clearance rate among carcinogenic HPV types.…”

Section: Discussioncontrasting

confidence: 65%

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Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

Mane

Sahasrabuddhe

Nirmalkar

et al. 2017

Journal of Clinical Virology

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Background Several studies in recent years have documented the genotype-specific prevalence of HPV infection and wide diversity and multiplicity of HPV genotypes among HIV-seropositive women. Yet, information on changes in HPV genotype-specific incidence and clearance rates over time, and their correlation with clinical or immunologic factors among HIV-seropositive women is scarce. Objectives We conducted a prospective study to investigate the incidence and clearance rates of cervical HPV genotypes among HIV-seropositive women in India and expand the evidence base in this area of research. Study design Cervical samples were collected from n=215 HIV-seropositive women in Pune, India who underwent two screening visits separated by a median of 11-months (interquartile range: 8–18 months). HPV genotypes were determined by Roche Linear Array HPV assay. Individual genotype-specific and carcinogenicity-grouping-specific HPV incidence and clearance rates were calculated and the associations between incidence/clearance and age and HIV-related metrics were explored. Results Incidence and clearance rates for ‘any HPV’ and ‘carcinogenic HPV’ genotypes were 11.1 and 18.3, and 6.7 and 33.8, per 100 person-years, respectively. Incidence and clearance rates for HPV genotypes of alpha-9 species (HPV16, HPV31, HPV33, HPV35, HPV52 and HPV58) and alpha-7 species (HPV18, HPV39, HPV45, HPV59 and HPV68) were 5.8 and 2.04, and 32.1 and 53.5, per 100 person-years, respectively. Clearance of any HPV type was associated with increasing age of participants (odds ratio: 1.08, 95%CI: 1.004–1.17), although the association marginally lost its statistical significance when adjusted for CD4 counts and antiretroviral therapy status. Conclusions Genotype-specific clearance rates of HPV were higher than corresponding incidence rates. The suggestion of a positive associations of increasing age with HPV clearance points to the need for etiologic studies on age-related hormonal changes on clearance of cervical HPV infection.

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Section: Discussioncontrasting

confidence: 65%

“…Written, informed consent was obtained from all participants. The description of the study population and the HPV genotyping results at baseline has been published in an earlier report 8 . Participants enrolled in this study were invited to return for clinical follow-up after 12 months of their initial visit.…”

Section: Methodsmentioning

confidence: 99%

Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

Mane

Sahasrabuddhe

Nirmalkar

et al. 2017

Journal of Clinical Virology

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“…However, the higher diagnostic accuracy of the molecular methods implemented in our study might have positively affected the sensitivity of the survey, explaining, consequently, the differences found comparing our findings with the results of other studies, which used different diagnostic techniques [19]. Recent epidemiological studies showing high HPV-51 frequency in several geographical areas could support the hypothesis of previous underreporting for some HPV types owing to less sensitive tools [20], [21], [22], [23], [24], [25], even if HPV-51 is frequently detected in co-infection with other types mainly in developing countries, characterized by a higher HPV genotype variability and HIV-infection [26], [27], [28], [29], [30]. Based on this assumption, the epidemiological differences identified in several areas might be reduced in the near future scaling-up new sensitive methods.…”

Section: Discussionmentioning

confidence: 80%

High HPV-51 Prevalence in Invasive Cervical Cancers: Results of a Pre-Immunization Survey in North Sardinia, Italy

et al. 2013

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BackgroundHuman Papilloma virus (HPV) is recognized as the etiological agent of benign and malignant ano-genital lesions. The most prevalent genotypes associated with cervical carcinoma are HPV-16 and -18 worldwide. However, recent studies have emphasized the role of other genotypes, such as HPV-51, in the pathogenesis of cervical dysplasia. The aim of the study was to estimate the burden of HPV-51 infection in invasive cervical malignant lesions in Northern Sardinia, Italy.Methods/Principal FindingsAn observational, retrospective, prevalence, mono-center study was carried out to evaluate the presence of HPV genotypes in tissues biopsies of cervical lesions (CIN-1, CIN-2, CIN-3 and invasive carcinoma) gathered from 1996 to 2009. Biological samples were collected from women admitted consecutively to a tertiary university hospital situated in Sassari, Italy. Molecular methods were used to identify 28 oncogenic HPV types. A total of 155 formalin-fixed and paraffin-embedded cervical tissue samples were analyzed. Approximately half of the cervical lesions were classified as invasive carcinoma. HPV-DNA was detected in 71% of the samples, with a higher frequency (100%) in those categorized as invasive neoplasia. Mono- or co-infections were demonstrated in 45.8% and 25.8% of the cervical samples, respectively. Overall, the most prevalent HPV types were -16 (49%) and -51 (19.4%), with an increased frequency of detection associated with the severity of the cervical lesions.Conclusions/SignificanceThis survey highlights for the first time the relevant role of HPV-51 infection in the pathogenesis of invasive cervical cancer prior to the introduction of a vaccination program. Although a selection bias could have influenced the results, other recent studies have described the impact of HPV-51. This remarkable epidemiological element should be carefully evaluated, particularly in the view of opting for preventive vaccines, whose cross-protection patterns determine their efficacy in protecting against infection from HPV types that are not included in the vaccine itself.

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“…We observed that the decrement in sensitivity was more for careHPV testing than for HC2; however, self-sampling does not reduce specificity for care-HPV and only slightly for HC2. The specificity of the OncoE6 for cervical precancer and cancer raises the possibility of its application to screening high HPV-prevalence, high-risk populations, such as for cervical (21)(22)(23)(24)(25) and anal cancer (26) in HIV-infected women and anal cancer in HIV-infected (27)(28)(29) and -uninfected men (30) who have sex with men. VIA is commonly used in low and middle-income countries (LMIC) achieving a moderate sensitivity with low specificity (31)(32)(33).…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of Novel, Lower-Cost Molecular Screening Tests for Human Papillomavirus in Rural China

Zhao

Jerónimo

Qiao

et al. 2013

Cancer Prevention Research

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New, lower-cost tests that target high-risk human papillomavirus (HR-HPV) have been developed for cervical cancer screening in lower-resource settings but large, population-based screening studies are lacking. Women ages 25 to 65 years and living in rural China (n ¼ 7,543) self-collected a cervicovaginal specimen, had 2 cervical specimens collected by a clinician, and underwent visual inspection after acetic acid (VIA). The self-and one clinician-collected specimens underwent HR-HPV DNA testing by careHPV (QIAGEN) and Hybrid Capture 2 (HC2; QIAGEN) and the other clinician-collected specimen was tested for HPV16, 18, and 45 E6 using OncoE6 (Arbor Vita Corporation). Women who screened positive for any test and a random sample of those negative on all tests underwent colposcopic evaluation. The percent test positive was 1.8% for HPV E6 oncoprotein, between 14% and 18% for HR-HPV DNA testing, and 7.3% for VIA. The sensitivity for cervical intraepithelial neoplasia grade 3 or more severe (CIN3 þ ; n ¼ 99) was 53.5% for OncoE6, 97.0% for both careHPV and HC2 testing of the clinician-collected specimen, 83.8% for careHPV testing and 90.9% for HC2 testing of the self-collected specimen, and 50.5% for VIA. OncoE6 had the greatest positive predictive value (PPV), at 40.8% for CIN3 þ , compared with the other tests, which had a PPV of less than 10%. OncoE6 tested 70.3% positive for HPV16, 18, or 45-positive CIN3 þ and tested negative for all HPV16-, 18-, or 45-negative CIN3 þ (P < 0.0001). HPV E6 oncoprotein detection is useful for identifying women who have cervical precancer and cancer. Cancer Prev Res; 6(9); 938-48. Ó2013 AACR.

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HPV Genotype Distribution in Cervical Intraepithelial Neoplasia among HIV-Infected Women in Pune, India

Cited by 34 publications

References 38 publications

Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

High HPV-51 Prevalence in Invasive Cervical Cancers: Results of a Pre-Immunization Survey in North Sardinia, Italy

An Evaluation of Novel, Lower-Cost Molecular Screening Tests for Human Papillomavirus in Rural China

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