title: Human Papillomavirus infection and cervical lesions in HIV infected women on antiretroviral treatment in Thailand.
abstract: To estimate the prevalence and factors associated with Human Papillomavirus (HPV) infection, HPV genotypes and cytological/histological high-grade (HSIL+/CIN2+) lesions.
  
  
  
  We conducted a cross-sectional study within a prospective cohort of HIV-infected women on combination antiretroviral therapy (cART). Cervical specimens were collected for cytology and HPV genotyping (Papillocheck®). Any women with High-Risk-HPV (HR-HPV), and/or potentially HR-HPV (pHR-HPV) and/or ASC-US or higher (ASC-US+) lesions were referred for colposcopy. Factors associated with HR-HPV infection and with HSIL+/CIN2+ lesions were investigated using mixed-effects logistic regression models.
  
  
  
  829 women were enrolled: median age 40.4 years, on cART for a median of 6.9 years, median CD4 cell-count 536 cells/mm3, and 788 (96%) with HIV-viral load<50copies/mL. Of 214 (26%) infected with HPV: 159 (19%) had ≥1 HR-HPV, of whom 38 (5%) HPV52, 22 (3%) HPV16, 9 (1%) HPV18; 21 (3%) had pHR-HPV, 34 (4%) low risk-HPV infection, and 56 (26%) had multiple genotypes. Younger age, low CD4 cell-counts and low education were independently associated with HR-HPV infection. 72 women (9%) had ASC-US+ and 28 (3%) HSIL+/CIN2+ lesions. HR-HPV infection was independently associated with HSIL+/CIN2+ lesions.
  
  
  
  The prevalence of HPV infection and of cervical lesions was low. The HPV genotype distribution supports the use of 9-valent vaccine in Thailand.
authors.affiliation: Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; APHP, Service de maladies infectieuses et tropicales, hôpital Saint Louis, F-75010, Paris, France; Institut National d'Etudes Démographiques (Ined), UR-5, Paris, France. Electronic address: delory.tristan@gmail.com.
authors.forename: Tristan
authors.initials: T
authors.lastname: Delory
authors.affiliation: Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; Harvard T.H. Chan School of Public Health, Boston, MA, United States.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ngo-Giang-Huong
authors.affiliation: Faculty of Medicine, Department of Pathology, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Samreung
authors.initials: S
authors.lastname: Rangdaeng
authors.affiliation: Ministry of Public Health, Chonburi Hospital, Chonburi, Thailand.
authors.forename: Nantasak
authors.initials: N
authors.lastname: Chotivanich
authors.affiliation: Ministry of Public Health, Nakornping Hospital, Chiang Mai, Thailand.
authors.forename: Aram
authors.initials: A
authors.lastname: Limtrakul
authors.affiliation: Ministry of Public Health, Chiang Kham Hospital, Chiang Kham, Thailand.
authors.forename: Chaiwat
authors.initials: C
authors.lastname: Putiyanun
authors.affiliation: Ministry of Public Health, Phayao Hospital, Phayao, Thailand.
authors.forename: Pornnapa
authors.initials: P
authors.lastname: Suriyachai
authors.affiliation: Ministry of Public Health, Lamphun Hospital, Lamphun, Thailand.
authors.forename: Wanmanee
authors.initials: W
authors.lastname: Matanasarawut
authors.affiliation: Ministry of Public Health, Hat Yai Hospital, Hat Yai, Thailand.
authors.forename: Tapnarong
authors.initials: T
authors.lastname: Jarupanich
authors.affiliation: Ministry of Public Health, Lampang Hospital, Lampang, Thailand.
authors.forename: Prateung
authors.initials: P
authors.lastname: Liampongsabuddhi
authors.affiliation: HPV National Reference Center, Pasteur Institute, Paris, France; APHP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Heard
authors.affiliation: Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; Harvard T.H. Chan School of Public Health, Boston, MA, United States.
authors.forename: Gonzague
authors.initials: G
authors.lastname: Jourdain
authors.affiliation: Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; Harvard T.H. Chan School of Public Health, Boston, MA, United States.
authors.forename: Marc
authors.initials: M
authors.lastname: Lallemant
authors.affiliation: Institut de recherche pour le développement (IRD) UMI 174-PHPT, Marseille, France; Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; Institut National d'Etudes Démographiques (Ined), UR-5, Paris, France; Harvard T.H. Chan School of Public Health, Boston, MA, United States.
authors.forename: Sophie
authors.initials: S
authors.lastname: Le Coeur
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000821:virology; D013785:Thailand / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000453:epidemiology / Q000821:virology
chemical_list: D044966:Anti-Retroviral Agents
keywords: Antiretroviral therapy; Cancer; Cervical lesions; Cross-sectional study; HIV; HPV; Thailand; Women