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Cancer Epidemiology, Biomarkers & Prevention
Cancer Epidemiology, Biomarkers & Prevention
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HPV Types in Cervical Precancer by HIV Status and Birth Region: A Population-Based Register Study

Christina Carlander, Camilla Lagheden, Carina Eklund, Sara Nordqvist Kleppe, Mensur Dzabic, Philippe Wagner, Aylin Yilmaz, Kristina Elfgren, Anders Sönnerborg, Pär Sparén and Joakim Dillner
Christina Carlander
1Unit of Infectious Diseases, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
2Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Uppsala, Sweden.
3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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  • For correspondence: christina.carlander@ki.se
Camilla Lagheden
4Division of Clinical Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
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Carina Eklund
4Division of Clinical Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
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Sara Nordqvist Kleppe
4Division of Clinical Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
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Mensur Dzabic
4Division of Clinical Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
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Philippe Wagner
2Centre for Clinical Research Västmanland, Västmanland County Hospital, Uppsala University, Uppsala, Sweden.
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Aylin Yilmaz
5Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Kristina Elfgren
6CLINTEC, Department of Obstetrics and Gynaecology, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
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Anders Sönnerborg
1Unit of Infectious Diseases, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
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Pär Sparén
3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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Joakim Dillner
4Division of Clinical Pathology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.
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DOI: 10.1158/1055-9965.EPI-20-0969 Published December 2020
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Abstract

Background: Data are lacking regarding which human papillomavirus (HPV) types cause high-grade cervical neoplasia (CIN2+) in people with HIV in Europe. We assessed which HPV types are associated with CIN2+ in women living in Sweden by HIV status.

Methods: The Swedish National HIV Registry, the Swedish Population Registry, and the Swedish National Cervical Screening Registry were linked. CIN2+ tissue blocks of 130 women living with HIV (WLWH) and 234 HIV-negative women, matched for country of birth (1:2), were retrieved from bio-banks and HPV genotyped. Adjusted ORs (adjOR), stratified by country of birth, were calculated using conditional logistic regression. Matching was broken for cross-group comparisons.

Results: WLWH with CIN2 were less likely to have HPV16 [14% vs. 40%; adjOR 0.1; 95% confidence interval (CI), 0.04–0.56] than HIV-negative women, but among women with CIN3, there was no difference in HPV16 prevalence by HIV status (adjOR 0.9; 95% CI, 0.51–1.70). WLWH were six times more likely to have HPV35 in CIN3 than HIV-negative women (adjOR 6.2; 95% CI, 1.3–30.4). WLWH from sub-Saharan Africa (SSA) had less 9-valent vaccine types, compared with both HIV-negative women born in Sweden (adjOR 0.1; 95% CI, 0.02–0.44) and WLWH born in Sweden (adjOR 0.1; 95% CI, 0.01–0.73), mostly because of decreased HPV16 and increased HPV35.

Conclusions: WLWH from SSA were less likely to be covered by the 9-valent vaccine, mostly due to less HPV16 and more HPV35.

Impact: This could have implications for HPV vaccines, currently not including HPV35, and for HPV-screening algorithms in women with origin from SSA.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Epidemiology, Biomarkers & Prevention Online (http://cebp.aacrjournals.org/).

  • Cancer Epidemiol Biomarkers Prev 2020;29:2662–8

  • Received June 24, 2020.
  • Revision received September 1, 2020.
  • Accepted September 18, 2020.
  • Published first September 23, 2020.
  • ©2020 American Association for Cancer Research.
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Cancer Epidemiology Biomarkers & Prevention: 29 (12)
December 2020
Volume 29, Issue 12
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HPV Types in Cervical Precancer by HIV Status and Birth Region: A Population-Based Register Study
Christina Carlander, Camilla Lagheden, Carina Eklund, Sara Nordqvist Kleppe, Mensur Dzabic, Philippe Wagner, Aylin Yilmaz, Kristina Elfgren, Anders Sönnerborg, Pär Sparén and Joakim Dillner
Cancer Epidemiol Biomarkers Prev December 1 2020 (29) (12) 2662-2668; DOI: 10.1158/1055-9965.EPI-20-0969

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HPV Types in Cervical Precancer by HIV Status and Birth Region: A Population-Based Register Study
Christina Carlander, Camilla Lagheden, Carina Eklund, Sara Nordqvist Kleppe, Mensur Dzabic, Philippe Wagner, Aylin Yilmaz, Kristina Elfgren, Anders Sönnerborg, Pär Sparén and Joakim Dillner
Cancer Epidemiol Biomarkers Prev December 1 2020 (29) (12) 2662-2668; DOI: 10.1158/1055-9965.EPI-20-0969
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