Analysis Of High-risk HPV Infection In Cervix Of HIV-positive Women And Its Risk Factors

Objective:Through questionnaires on women infected with human immunodeficiency virus(HIV)and standardized screening for cervical cancer in Yunnan Province,we understand the infection of high-risk human papillomavirus(HR-HPV)in HIV-infected women and the relationship between cervical lesions and HR-HPV infection,and explore the risk factors of HR-HPV infection in HIV-infected women combined with the results of questionnaires.To provide a theoretical basis for the prevention of HR-HPV infection and cervical cancer in HIV-positive women,as well as a reference for the management and control of HR-HPV infection and cervical cancer in HIV-positive women.Methods:1.181 HIV-positive women who met the inclusion criteria were recruited from January 21,2019 to February 25,2019 in the clinical management system of HIV antiviral therapy in the Third People's Hospital of Kunming City,Yunnan Province.After registration and informed consent,a questionnaire was filled in.Gynecologists performed gynecological examinations on the subjects and recorded cervical inflammation.After that,gynecologists collected human papilloma virus(HPV)specimens and liquid-based cytologic test(TCT).All HPV and TCT specimens were transported to Shengxiang Biotechnology Co.,Ltd.for testing.2.Any positive HR-HPV test results or atypical squamouscells of undetermined significance(ASCUS)with no clear diagnostic significance by cytology were recalled for colposcopy.Colposcopy abnormal biopsy,colposcopy is not satisfied with the endocervical curettage(ECC),colposcopy specimens will be sent to Kunming Golden Domain Medical Inspection Institute for pathological examination.3.To find out the most recent CD4+T cells of the study subjects in the clinical management system of HIV antiviral therapy of the Third People's Hospital of Kunming,Yunnan Province.According to the results of HR-HPV testing,the study subjects were divided into experimental group(HR-HPV positive)and control group(HR-HPV negative).The risk factors of HR-HPV infection in HIV-infected women were statistically analyzed with SPSS24.0 statistical software combined with questionnaire survey.Results:1.The average age of 181 HIV-positive women was 42.08+8.371(22-63 years).The data of this study showed that the education level,economic ability and awareness of cervical cancer screening of HIV-positive women were generally low.126(69.6%)women had education level below junior high school,111(61.3%)had family income below 30,000,and only 126(69.6%)had heard of cervical cancer screening.2.Among 181 screened subjects,58(32.0%,58/181)were positive for HR-HPV testing,including 15 cases(25.9%,15/58)with overlapping infection of HPV subtypes,including 2 cases with 4 types of HR-HPV infection,3 cases with 3 types of HR-HPV infection,and 10 cases with 2 types of HR-HPV infection.The top five detection rates of HR-HPV were HPV52(11.6%,21/181),HPV58(5.5%),HPV53(5.0%),HPV16(3.9%)and HPV33(3.3%).3.There were 92 cases(50.8%)who should be recalled for colposcopy,and 79 cases(43.6%)were actually recalled,of which 42 cases(23.2%)underwent cervical biopsy or ECC.Of these 42 cases,31 cases(73.8%)were infected with HR-HPV.The examination showed that 9 cases(5.0%)were low-grade squamous intraepithelial lesion(LSIL),4 cases(2.2%)were high-grade squamous intraepithelial lesion(HSIL),and 29 cases(16.0%)had no cervical intraepithelial neoplasia(CIN)(cervicitis in 28 cases,condyloma acuminatum in 1 case).Four of.them(6.9%,4/58)had HSIL,all of them were HR-HPV repeated infection(infection types:16/18,33/39;45/52/58,16/33/39/68).4.Univariate analysis showed that there were significant differences between the experimental group and the control group in CD4+T cell count,age of first sexual life,whether condom was used or not(p<0.05).5.Including all univariate factors into binomial logistic regression analysis showed that age at first sexual life<20,CD4+T cell count<400/uL and not using condom were risk factors for HR-HPV infection.Conclusions:1.HIV-positive women generally have lower education level,economic ability and awareness of cervical cancer screening2.HR-HPV infection rate of HIV-positive women is higher than that of ordinary women.3.The highest detection rate of HR-HPV subtypes in HIV-positive women was HPV52(11.6%).4.Early age of first sexual life,CD4+T cell count<400/uL and no use of condom in HIV-positive women are risk factors for HR-HPV infection.