Cervico-vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: High acceptability, hrHPV diversity and risk factors
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open access
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2018
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Elsevier
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Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro, RJ, Brasil / Instituto de Saúde Coletiva. Universidade Federal do Oeste do Pará, Santarém, PA, Brasil
Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil
Division of Cancer Prevention, National Cancer Institute. Bethesda, MD, USA
Laboratório de Virologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil
Programa de Pós-Graduação em Patologia. Universidade Federal Fluminense, Niterói, RJ, Brasil
Norris Comprehensive Cancer Center. University of Southern California. Los Angeles, CA, USA
Norris Comprehensive Cancer Center. University of Southern California, Los Angeles, CA, USA / Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA / Department of Obstetrics and Gynecology. University of Southern California, Los Angeles, CA, USA / Department of Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA, USA
Instituto Nacional de Infectologia Evandro Chagas, INI-FIOCRUZ, Rio de Janeiro, RJ, Brasil / Laboratório Interdisciplinar de Pesquisas Médicas, IOC-FIOCRUZ, Rio de Janeiro, RJ, Brasil
Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil
Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil
Division of Cancer Prevention, National Cancer Institute. Bethesda, MD, USA
Laboratório de Virologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil
Programa de Pós-Graduação em Patologia. Universidade Federal Fluminense, Niterói, RJ, Brasil
Norris Comprehensive Cancer Center. University of Southern California. Los Angeles, CA, USA
Norris Comprehensive Cancer Center. University of Southern California, Los Angeles, CA, USA / Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA / Department of Obstetrics and Gynecology. University of Southern California, Los Angeles, CA, USA / Department of Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA, USA
Instituto Nacional de Infectologia Evandro Chagas, INI-FIOCRUZ, Rio de Janeiro, RJ, Brasil / Laboratório Interdisciplinar de Pesquisas Médicas, IOC-FIOCRUZ, Rio de Janeiro, RJ, Brasil
Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ. Rio de Janeiro, RJ, Brasil
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Abstract
Abstract
Objective We evaluated acceptability of cervico-vaginal self-collection (CVSC) and prevalence of human papillomavirus (HPV) in Human immunodeficiency virus (HIV)-infected and HIV-uninfected women living in the Tapajós region, Amazon, Brazil. Methods Cross-sectional study recruited 153 non-indigenous women (HIV-uninfected, n = 112 and HIV-infected, n = 41) who voluntarily sought assistance in health services. Peripheral blood for HIV screening and cervical scraping (CS) for HPV detection were collected. Women who accepted to perform CVSC received instructions and individual collection kits. Risk factors for high-risk HPV genotypes (hrHPV) were identified by uni- and multivariate analyses. Results The overall acceptability of CVSC was 87%. Only HIV-infected women had cytological abnormalities (12.2%). Prevalence of any HPV and hrHPV infection was 42.9% and 47.9% for HIV-uninfected and 97.6% and 77.5% for HIV-infected women, respectively. There was significant agreement in the detection of HPV (88%, 0.76, 95% confidence interval [CI], 0.65–0.87) and hrHPV (79.7%, 0.56, 95% CI, 0.41–0.71) between self-collected and clinician-collected samples. The most prevalent hrHPV types were HPV16 and HPV18 in HIV-uninfected and HPV16, HPV51 and HPV59 in HIV-infected women. HIV-infected women with hrHPV infection had multiple hrHPV infections (p = 0.005) and lower CD4 count (p = 0.018). Risk factors for hrHPV infection included being HIV-infected and having five or more sexual partners. Conclusions CVSC had high acceptability and high prevalence of hrHPV types in women living in the Tapajós region, Amazon, Brazil.
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HIV, HPV, Amazonas, Brasil, Índios Sul-Americanos, Região Norte, Saúde de Populações Indígenas, Região Amazônica, Epidemiologia, Síndrome de Imunodeficiência Adquirida, Doenças Sexualmente Transmissíveis, Saúde da Mulher, Papanicolau
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Brasil, Saúde de Populações Indígenas, Índios Sul-Americanos, Ecossistema Amazônico, Epidemiologia, Síndrome de Imunodeficiência Adquirida, Doenças Sexualmente Transmissíveis, Saúde da Mulher, Teste de Papanicolaou
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RODRIGUES, Luana L. S.; et al . Cervico-vaginal self-collection in HIV-infected and uninfected women from Tapajós region, Amazon, Brazil: High acceptability, hrHPV diversity and risk factors. Gynecologic Oncology, v. 151, n.1 , p. 102-110, 2018.
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0090-8258
DOI
10.1016/j.ygyno.2018.08.004