Background High-risk human papillomavirus (HR-HPV) is the primary cause of cervical cancer, leading to over 311 000 global deaths, mainly in low- and middle-income countries. Kenyan women living with HIV (WLHIV) face a disproportionate burden of HR-HPV. Objectives We determined the prevalence of HR-HPV infections and their association with cervical cytology findings among Kenyan WLHIV. Method We conducted a cross-sectional study among WLHIV attending the HIV care and treatment clinic at the Kenyatta National Hospital (KNH), Kenya's national referral hospital. Study nurses collected a cervical sample with a cytobrush for HR-HPV genotyping using Gene Xpert® assays and HPV Genotypes 14 Real-TM Quant V67-100FRT. Bivariate analysis explored the associations. Results We enrolled 647 WLHIV (mean age of 42.8 years), with 97.2% on antiretroviral therapy (ART) and 79% with a suppressed viral load (< 50 copies/mL plasma). The prevalence of any and vaccine-preventable HR-HPV was 34.6% and 29.4%, respectively, with HPV 52 being the most common genotype (13.4%). Among WLHIV with HR-HPV infections, 21.4% had abnormal cervical cytology. Women with multiple HR-HPV infections were more likely to have abnormal cytology compared to those with single HR-HPV infections (34.9 vs 9.3%, adjusted odds ratio [aOR] = 6.2, 95% confidence interval [CI]: 2.7-14.1, P = 0.001). Women with HR-HPV infection (single or multiple) were more likely to be on the second-line ART regimen compared to those without HR-HPV infections (53.1% vs 46.7%, aOR = 2.3, 95% CI: 1.3-4.1, P = 0.005). Conclusion Among WLHIV at KNH, abnormal cytology was common and more frequent among women with multiple HR-HPV infections.

中文翻译：

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面对人乳头瘤病毒与艾滋病毒的交叉：宫颈细胞学对感染艾滋病毒的肯尼亚妇女的影响。

背景 高危人乳头瘤病毒 (HR-HPV) 是宫颈癌的主要原因，导致全球超过 311 000 人死亡，主要发生在低收入和中等收入国家。感染艾滋病毒 (WLHIV) 的肯尼亚妇女面临着不成比例的 HR-HPV 负担。目的 我们确定了肯尼亚 WLHIV 患者中 HR-HPV 感染的患病率及其与宫颈细胞学检查结果的关联。方法 我们对在肯尼亚国家转诊医院肯雅塔国家医院 (KNH) 的艾滋病毒护理和治疗诊所就诊的 WLHIV 患者进行了一项横断面研究。研究护士使用细胞刷收集宫颈样本，使用 Gene Xpert® 检测和 HPV Genotypes 14 Real-TM Quant V67-100FRT 进行 HR-HPV 基因分型。双变量分析探讨了这些关联。结果 我们招募了 647 名 WLHIV 患者（平均年龄 42.8 岁），其中 97.2% 接受抗逆转录病毒治疗 (ART)，79% 接受病毒载量抑制（< 50 拷贝/mL 血浆）。任何 HR-HPV 和疫苗可预防的 HR-HPV 的患病率分别为 34.6% 和 29.4%，其中 HPV 52 是最常见的基因型 (13.4%)。在HR-HPV感染的WLHIV中，21.4%的宫颈细胞学异常。与单一 HR-HPV 感染的女性相比，多重 HR-HPV 感染的女性更有可能出现细胞学异常（34.9 vs 9.3%，调整后比值比 [aOR] = 6.2，95% 置信区间 [CI]：2.7-14.1， P = 0.001）。与未感染 HR-HPV 的女性相比，感染 HR-HPV（单发或多发）的女性更有可能接受二线 ART 治疗（53.1% vs 46.7%，aOR = 2.3，95% CI：1.3-4.1， P = 0.005）。结论 在 KNH 的 WLHIV 中，细胞学异常很常见，并且在多重 HR-HPV 感染的女性中更为常见。