title: Human papillomavirus DNA and mRNA prevalence and association with cervical cytological abnormalities in the Irish HIV population.
abstract: The complex interplay between HIV and human papillomavirus and its link to cervical dysplasia is poorly understood. This is the first study to assess the prevalence of oncogenic human papillomavirus mRNA in HIV-positive women, its relationship to HIV and its potential use in the triage of cervical cancer screening in HIV-positive women. In this cross-sectional study, we included 321 HIV-positive women. In all, 28.7% had abnormal cervical cytology, 51.1% were human papillomavirus DNA-positive and 21.8% tested positive for human papillomavirus mRNA. Women with a CD4 count of <200 × 10(6)/L were more likely to test positive for human papillomavirus DNA and mRNA. Virally suppressed women were less likely to be human papillomavirus DNA-positive; however, the same did not hold true for human papillomavirus mRNA. We found the human papillomavirus mRNA screening to be more specific when screening for low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion than human papillomavirus DNA at 84.53% compared to 57.36%. However, the sensitivity was less at 51.59% versus 91.07% for human papillomavirus DNA. It may be possible in the future to use human papillomavirus mRNA/DNA testing within a triage algorithm for the screening and management of cervical cancer in the HIV-positive patient.
authors.affiliation: Genito-Urinary Infectious Disease Department, St James's Hospital, Dublin, Ireland aisloy@yahoo.ie.
authors.forename: Aisling
authors.initials: A
authors.lastname: Loy
authors.affiliation: The Coombe Woman and Infants University Hospital, Dublin, Ireland.
authors.forename: Jamie
authors.initials: J
authors.lastname: McInerney
authors.affiliation: The Coombe Woman and Infants University Hospital, Dublin, Ireland.
authors.forename: Loretto
authors.initials: L
authors.lastname: Pilkington
authors.affiliation: The Coombe Woman and Infants University Hospital, Dublin, Ireland Department of Histopathology, Trinity College Dublin, Dublin, Ireland.
authors.forename: Helen
authors.initials: H
authors.lastname: Keegan
authors.affiliation: Genito-Urinary Infectious Disease Department, St James's Hospital, Dublin, Ireland.
authors.forename: Sandra
authors.initials: S
authors.lastname: Delamere
authors.affiliation: The Coombe Woman and Infants University Hospital, Dublin, Ireland Department of Histopathology, Trinity College Dublin, Dublin, Ireland.
authors.forename: Cara M
authors.initials: CM
authors.lastname: Martin
authors.affiliation: Department of Histopathology, Trinity College Dublin, Dublin, Ireland.
authors.forename: Orla
authors.initials: O
authors.lastname: Sheils
authors.affiliation: The Coombe Woman and Infants University Hospital, Dublin, Ireland Department of Histopathology, Trinity College Dublin, Dublin, Ireland.
authors.forename: John J
authors.initials: JJ
authors.lastname: O'Leary
authors.affiliation: Genito-Urinary Infectious Disease Department, St James's Hospital, Dublin, Ireland.
authors.forename: Fiona
authors.initials: F
authors.lastname: Mulcahy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D015995:Prevalence; D012333:RNA, Messenger / Q000235:genetics; D014218:Triage / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D014626:Vaginal Smears / Q000379:methods*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology
chemical_list: D004279:DNA, Viral; D012333:RNA, Messenger
keywords: AIDS; CIN; Europe; HIV; HPV; cervical dysplasia; human papillomavirus; sexually transmitted infection; women