| Objectives: To know the prevalence and of Human Papillomavirus,and the distribution of Human Papillomavirus and cervical lesion among the HIV-1 positive population;To evaluate the clinical performance of dry storage medium(FTA Elute card)applied to high risk human papillomavirus detection among HIV-1 positive population,compared to a Preserv Cyt medium.Methods: Three hundreds of eligible HIV-1 positive women were recruited from Yunnan infectious hospital in May 2013.Two samples were collected from each participant: one collected by a physician and stored in Preserv Cyt for Thinprep cytology test and HR-HPV detection.The other collected by women themselves and applied on FTA Elute card for the evaluation the feasibility of FTA card in testing HR-HPV.Then the samples were tested with Abbott m2000 rt HR-HPV assay for the detection of 14 HR-HPV(16,18,other types HR-HPV).Biopsies were taken for histological diagnosis if abnormal impression was noticed under colposcopy.Database was established by Microsoft Excel 2007,and analyzed by SPSS 16.0Results:1.The age mean of participants was 39.2±7.85 in years,263(90.4%)were married and 35.7% of them had a high school and above educational level.33.7% and 30.6% women had a history of smoke and drink.>40% had 3 or over 3 sexual partners,20.3% had a history of drug abuse,16.8% had a history of blood transfusion.Median CD4 count was 448 cells/mm3(range: 11-1360),and 264(90.7%)participants received HAART.2.116/291 women was HR-HPV positive.The positive rate of HPV16,HPV18 and non-16/18 was 7.2%,3.8% and 35.7% respectively.The highest positive rate(47.8%)of HR-HPV was found in the subgroup of 50+ years.No trend was noticed between age and HR-HPV positive rate(P trend>0.1).43 women were diagnosed as abnormal cytology and 35 as LISL 8 as HISL.Cervical lesions(Cytology and Histology)level was increasing with HR-HPV positive rate(P trend<0.001).3.According to the classification of immunity,women had high,middle and low immunity was 39.5%,51.2% and 9.3%.No significant difference of HR-HPV positive was found in these three subgroups(P >0.1).A negative correlation was observed between cervical lesions and CD4 count(P trend<0.01).4.No significant difference was found in HPV16 and HPV18 result of PCR between the samples collected by two methods,while a lightly difference was found in non-16/18 type.5.In all,253 participants had consistent result of overall HR-HPV,results in a crude agreement of 86.9% and Kappa 0.73.The positive agreement of HPV16,HPV18 and non-16/18 type was 73.9%,46.7% and 70.5%.In the CIN2+ subgroup,the agreement of overall HR-HPV was 100.0%.Conclusions:1.In this study,the prevalence of HR-HPV and cervical lesions was high,and the cervical lesion positive rate increased with CD4 count.2.FTA Elute card demonstrated a good performance on self-collected samples for HR-HPV testing in HIV-1 positive population.For the women from low-resource area and HIV-1 positive population,FTA Elute card could be an attractive alternative to a liquid-based medium for the detection of HR-HPV in cervical cancer screening. |
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