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Angela RI Meyrelles Juliana D Siqueira Pamela P dos Santos Cristina B Hofer Ronir R Luiz Héctor N Seuánez Gutemberg Almeida Marcelo A Soares Esmeralda A Soares Elizabeth S Machado 《Memórias do Instituto Oswaldo Cruz》2016,111(2):120-127
This study investigated the rate of human papillomavirus (HPV) persistence,
associated risk factors, and predictors of cytological alteration outcomes in a
cohort of human immunodeficiency virus-infected pregnant women over an 18-month
period. HPV was typed through L1 gene sequencing in cervical smears
collected during gestation and at 12 months after delivery. Outcomes were defined as
nonpersistence (clearance of the HPV in the 2nd sample), re-infection (detection of
different types of HPV in the 2 samples), and type-specific HPV persistence (the same
HPV type found in both samples). An unfavourable cytological outcome was considered
when the second exam showed progression to squamous intraepithelial lesion or high
squamous intraepithelial lesion. Ninety patients were studied. HPV DNA persistence
occurred in 50% of the cases composed of type-specific persistence (30%) or
re-infection (20%). A low CD4+T-cell count at entry was a risk factor for
type-specific, re-infection, or HPV DNA persistence. The odds ratio (OR) was almost
three times higher in the type-specific group when compared with the re-infection
group (OR = 2.8; 95% confidence interval: 0.43-22.79). Our findings show that
bonafide (type-specific) HPV persistence is a stronger predictor for the development
of cytological abnormalities, highlighting the need for HPV typing as opposed to HPV
DNA testing in the clinical setting. 相似文献
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