Michel Segondy1, Jean Ngou2, Helen Kelly3, Tanvier Omar4, Olga Goumbri-Lompo5, Sylviane Doutre6, Philippe Mayaud3, Marie-Noelle Didelot7. 1. INSERM, EFS, University of Montpellier, Montpellier, France; Department of Biology and Pathology, University of Montpellier Hospital, Montpellier, France. Electronic address: m-segondy@chu-montpellier.fr. 2. INSERM, EFS, University of Montpellier, Montpellier, France. 3. Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK. 4. Department of Pathology, National Health Laboratory Services, Johannesburg, South Africa. 5. Department of Pathology, University Teaching Hospital Yalgado, Ouagadougou, Burkina Faso. 6. Department of Biology and Pathology, University of Montpellier Hospital, Montpellier, France. 7. INSERM, EFS, University of Montpellier, Montpellier, France; Department of Biology and Pathology, University of Montpellier Hospital, Montpellier, France.
Abstract
BACKGROUND: African women living with HIV (WLHIV) are at high risk of cervical cancer but rarely adequately screened. Better strategies enabling identification of WLHIV with high-grade cervical intraepithelial lesions (CIN2+) are required. OBJECTIVES: To investigate the diagnostic value of HPV16 and HPV18 viral loads in a cohort of African WLHIV. DESIGN: HPV16 and HPV18 viral loads were determined by quantitation of the E6 gene DNA by real-time PCR in cervical specimens collected at baseline and endline (16 months) from 245 African WLHIV positive for HPV16 or/and HPV18. Cervical biopsies were graded using the histopathological CIN classification. RESULTS: Women with CIN2+ had higher viral load for HPV16 (p < 0.0001) or HPV18 (p = 0.03) than those without CIN2+. HPV16 viral load ≥3.59 log copies/1000 cells detected CIN2+ with sensitivity and specificity of 93.5% (95%CI: 81.7-98.3%) and 74.1% (95%CI: 66.3-80.6%), respectively, whereas HPV18 viral load ≥1.63 log copies/1000 cells detected CIN2+ with sensitivity and specificity of 59.1% (95%CI: 38.7-76.7%) and 66.9% (95%CI: 58.8-74.1%), respectively. A high baseline HPV16 viral load was significantly associated with persistence of, or progression to CIN2+ at endline; these findings were not observed for HPV18. CONCLUSIONS: HPV16 viral load is a powerful marker of CIN2+ in African WLHIV. HPV18 viral load is of lower diagnostic value in this population.
BACKGROUND: African women living with HIV (WLHIV) are at high risk of cervical cancer but rarely adequately screened. Better strategies enabling identification of WLHIV with high-grade cervical intraepithelial lesions (CIN2+) are required. OBJECTIVES: To investigate the diagnostic value of HPV16 and HPV18 viral loads in a cohort of African WLHIV. DESIGN:HPV16 and HPV18 viral loads were determined by quantitation of the E6 gene DNA by real-time PCR in cervical specimens collected at baseline and endline (16 months) from 245 African WLHIV positive for HPV16 or/and HPV18. Cervical biopsies were graded using the histopathological CIN classification. RESULTS:Women with CIN2+ had higher viral load for HPV16 (p < 0.0001) or HPV18 (p = 0.03) than those without CIN2+. HPV16 viral load ≥3.59 log copies/1000 cells detected CIN2+ with sensitivity and specificity of 93.5% (95%CI: 81.7-98.3%) and 74.1% (95%CI: 66.3-80.6%), respectively, whereas HPV18 viral load ≥1.63 log copies/1000 cells detected CIN2+ with sensitivity and specificity of 59.1% (95%CI: 38.7-76.7%) and 66.9% (95%CI: 58.8-74.1%), respectively. A high baseline HPV16 viral load was significantly associated with persistence of, or progression to CIN2+ at endline; these findings were not observed for HPV18. CONCLUSIONS:HPV16 viral load is a powerful marker of CIN2+ in African WLHIV. HPV18 viral load is of lower diagnostic value in this population.
Authors: Admire Chikandiwa; Pedro T Pisa; Catherine Tamalet; Etienne E Muller; Pamela Michelow; Matthew F Chersich; Philippe Mayaud; Sinead Delany-Moretlwe Journal: PLoS One Date: 2019-12-05 Impact factor: 3.240