TY - JOUR
T1 - Epstein-Barr Virus, High-Risk Human Papillomavirus and Abnormal Cervical Cytology in a Prospective Cohort of African Female Sex Workers
AU - Cameron, Jennifer E.
AU - Rositch, Anne F.
AU - Vielot, Nadja A.
AU - Mugo, Nelly R.
AU - Kwatampora, Jessie K.L.
AU - Waweru, Wairimu
AU - Gilliland, Aubrey E.
AU - Hagensee, Michael E.
AU - Smith, Jennifer S.
N1 - Funding Information:
Conflict of Interest and Sources of Funding: J.S.S. has received unrestricted educational grants, consultancy, and research grants from Hologic Corporation, Trovagene, and BD Corporation over the past 5 years. All other authors have no conflicts to declare. This work was supported by Hologic, a UNC Center for AIDS Research grant (Grant No. 5-51060 awarded to J.S.S.), and the National Cancer Institute (supplement to the Lineberger Cancer Center awarded to J.S.S. and research grant R01 CA121979 awarded to M.E.H.). During the completion of this work, J.E.C. received support from the National Institute of General Medical Sciences through the Center of Biomedical Research Excellence (P20 GM103501) and the Louisiana Clinical and Translational Science Center (U54 GM104940), A.F.R. received support from the Johns Hopkins University Center for AIDS Research (P30 AI094189), and N.A.V. received support from the National Institute of Allergy and Infectious Diseases (T32 AI070114). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the sponsoring agencies and affiliate institutions.
Publisher Copyright:
© Lippincott Williams & Wilkins.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background High-oncogenic-risk human papillomavirus (hrHPV) is necessary, although insufficient, to promote cervical cancer. Like HPV, Epstein-Barr virus (EBV) is a common pathogen with the capacity to promote epithelial neoplasms. We examined the association between cervical EBV, hrHPV, and cytology in female sex workers in Nairobi, Kenya. Methods Women (n = 332) with known cervical cytology and hrHPV mRNA results were evaluated for cervical EBV DNA by conventional polymerase chain reaction. Prevalence ratios (PRs) were calculated to assess the relationships between EBV, hrHPV, and cervical cytology. Prospective analyses used risk ratios and time-to-event analyses to determine the association of EBV with hrHPV clearance and with abnormal cytology outcomes. Results Baseline prevalence of hrHPV and EBV was 29% and 19%, respectively. Higher EBV prevalence was found among women with older age, HIV, hrHPV, abnormal cytology, Mycoplasma genitalium infection, smoking habits, younger age at sexual debut, and less frequent condom use. At baseline, women with EBV had a higher prevalence of hrHPV infection than did EBV-negative women (52% vs. 24%; HIV-adjusted PR [95% confidence interval], 1.8 [1.3-2.6]). Epstein-Barr virus-positive women had a higher prevalence than did EBV-negative women of high-grade precancer (15% vs. 2%) and abnormal cytology (37% vs. 15%), although HIV- and hrHPV-adjusted associations were not significant (high-grade precancer: PR, 2.0 [0.7-5.9]; abnormal cytology: PR, 1.4 [0.9-2.2]). In prospective analyses, a marginal association was observed between baseline EBV detection and delayed hrHPV clearance. Conclusions Our data support a possible role for EBV as a high-risk marker or cofactor for HPV-mediated cervical cancer development.
AB - Background High-oncogenic-risk human papillomavirus (hrHPV) is necessary, although insufficient, to promote cervical cancer. Like HPV, Epstein-Barr virus (EBV) is a common pathogen with the capacity to promote epithelial neoplasms. We examined the association between cervical EBV, hrHPV, and cytology in female sex workers in Nairobi, Kenya. Methods Women (n = 332) with known cervical cytology and hrHPV mRNA results were evaluated for cervical EBV DNA by conventional polymerase chain reaction. Prevalence ratios (PRs) were calculated to assess the relationships between EBV, hrHPV, and cervical cytology. Prospective analyses used risk ratios and time-to-event analyses to determine the association of EBV with hrHPV clearance and with abnormal cytology outcomes. Results Baseline prevalence of hrHPV and EBV was 29% and 19%, respectively. Higher EBV prevalence was found among women with older age, HIV, hrHPV, abnormal cytology, Mycoplasma genitalium infection, smoking habits, younger age at sexual debut, and less frequent condom use. At baseline, women with EBV had a higher prevalence of hrHPV infection than did EBV-negative women (52% vs. 24%; HIV-adjusted PR [95% confidence interval], 1.8 [1.3-2.6]). Epstein-Barr virus-positive women had a higher prevalence than did EBV-negative women of high-grade precancer (15% vs. 2%) and abnormal cytology (37% vs. 15%), although HIV- and hrHPV-adjusted associations were not significant (high-grade precancer: PR, 2.0 [0.7-5.9]; abnormal cytology: PR, 1.4 [0.9-2.2]). In prospective analyses, a marginal association was observed between baseline EBV detection and delayed hrHPV clearance. Conclusions Our data support a possible role for EBV as a high-risk marker or cofactor for HPV-mediated cervical cancer development.
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U2 - 10.1097/OLQ.0000000000000857
DO - 10.1097/OLQ.0000000000000857
M3 - Article
C2 - 29664764
AN - SCOPUS:85053708416
SN - 0148-5717
VL - 45
SP - 666
EP - 672
JO - Sexually transmitted diseases
JF - Sexually transmitted diseases
IS - 10
ER -