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Human papillomavirus sequencing reveals its usefulness for the management of HIV ‐infected women at risk for developing cervical cancer
Author(s) -
Piyathilake Chandrika J.,
Kumar Ranjit,
Crowley Michael R.,
Badiga Suguna,
Burkholder Greer A.
Publication year - 2021
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14754
Subject(s) - ascus (bryozoa) , medicine , logistic regression , cervical cancer , human papillomavirus , genotype , odds ratio , obstetrics , gynecology , oncology , cancer , human immunodeficiency virus (hiv) , triage , virology , genetics , gene , biology , emergency medicine , botany , ascospore , spore
Aim Next‐generation sequencing (NGS) is able to describe the composition of human papillomaviruses (HPVs) as percent (%) reads rather than positive/negative results. Therefore, we used this unique approach to assess the prevalence of cervical HPVs of HIV infected (HIV+) in order to understand the determinants of being infected with higher % reads of high risk (HR)‐HPVs and cervical abnormalities of atypical squamous cells of unknown significance or higher (ASCUS+). Methods Study included 66 women characterized for relevant risk factors/cytology. Receiver‐operating curve curve was used to derive the optimal % read cut point to identify ASCUS+ in relation to any HR‐HPV genotype or other specific HPV genotypes. The determinants of ASCUS+ and HR‐HPVs were tested using logistic regression. Results Women with >20% reads of any HR‐HPV or >12% any HR‐HPV other than HPV 16/18 were 5.7 and 12.6 times more likely to be diagnosed with ASCUS+, respectively. Lower CD4 count was a significant determinant of >20% reads of HR‐HPV (odds ratio [OR] = 4.1) or >12% any HR‐HPV other than HPV 16/18 (OR = 4.5). Conclusion We envision that the NGS‐based HPV detection will be more accurate for screening and management of HIV+ at risk for developing cervical cancer (CC). We raise concerns regarding the limitations of 16/18‐based HPV testing for triage and the efficacy of current HPV vaccines for preventing CC in HIV+.