Novel methods for the diagnosis of HPV infection
Abstract number: P2149
Dalessandro M., Zappacosta R., Conti F., Santone T., Falasca K., Di Girolamo A., Ripani P., Liberati M., Rosini S., Pizzigallo E., Vecchiet J.
Introduction: Human Papilloma Virus (HPV) infection is more common among HIV positive women. HPV-associated lesions are more frequent, more aggressive, and less responsive to therapy when compared to seronegative women. Classic methods (gynaecological examination, transvaginal US-scan, colposcopy and Pap test) in association with molecular test such as Hybrid Capture 2 (HC-2, Digene Italy) are employed for diagnosis of HPV infection in HIV seronegative, and seropositive women. The purpose of this work is to evaluate the use of Pretect HPV Proofer for the detection of E6/E7 mRNA expression also in seropositive women.
Materials and Methods: We considered 25 HIV positive women admitted at the Clinic of Infectious Diseases of "G. d'Annunzio" University in Chieti. All women were evaluated with gynaecological examination, transvaginal US-scan and colposcopy. We have also used cytological techniques (Pap test) and molecular test (HC-2, and Pretect HPV Proofer).
Results: LSIL has been found in 28% of HIV positive women and HSIL in 8%. Abnormal cytology was more frequent among women with HIV viral load between 400 and 10.000 copies/ml (25% ASCUS, 42% LSIL e 100% HSIL), and lower CD4+ lymphocyte levels. Using HC-2 test HR-HPV genotype has been detected in 40% of women; 12% of women showed a positivity for LR, and HR-HPV infection. HPV infection is more common among women with high HIV viral load (p = 0.001; r = 0.62) and CD4 lymphocyte count below 500 cells/ml. A negative result for mRNA test was found in 68% of HIV+ women. The diagnosis of ANTZ was more frequent when HIV viral load was >10,000 copies/ml (p = 0.04; r = 0.43).
Discussion: HIV+ women are at higher risk for HR-HPV infection than uninfected women. This risk seem associated with high HIV viral load and low CD4 lymphocyte count. The role of HAART on HPV infection evolution toward cervical dysplasia and cancer is somewhat unclear. Molecular techniques for HPV diagnosis and typing are more specific and accurate, when compared with other methods. In HIV+ women PreTect HPV Proofer is a promsing new tool for the diagnosis of HPV infection, for identification high risk HPV genotypes, allowing a more reliable follow up of HIV-HPV coinfection.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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