P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV
BackgroundThe expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepitheli...
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| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1277480/full |
| _version_ | 1797662938318766080 |
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| author | Daniel Maina Michael H. Chung Marleen Temmerman Zahir Moloo Jonathan Wawire Sharon A. Greene Elizabeth R. Unger Nelly Mugo Samah Sakr Shahin Sayed Christine J. McGrath |
| author_facet | Daniel Maina Michael H. Chung Marleen Temmerman Zahir Moloo Jonathan Wawire Sharon A. Greene Elizabeth R. Unger Nelly Mugo Samah Sakr Shahin Sayed Christine J. McGrath |
| author_sort | Daniel Maina |
| collection | DOAJ |
| description | BackgroundThe expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepithelial lesions grade 2 or higher (CIN2+) following cryotherapy among women with HIV.MethodsThis is a subgroup analysis of women with HIV in Kenya with baseline cervical biopsy-confirmed CIN2+ who were randomized to receive cryotherapy and followed every six-months for two-years for biopsy-confirmed recurrence of CIN2+. P16 immunohistochemistry was performed on the baseline cervical biopsy with a positive result defined as strong abnormal nuclear expression in a continuous block segment of cells (at least 10–20 cells).ResultsAmong the 200 women with CIN2+ randomized to cryotherapy, 160 (80%) had a baseline cervical biopsy specimen available, of whom 94 (59%) were p16-positive. p16 expression at baseline was associated with presence of any one of 14 hrHPV genotypes [Odds Ratio (OR) = 3.2; 95% Confidence Interval (CI), 1.03–9.78], multiple lifetime sexual partners (OR = 1.6; 95% CI, 1.03–2.54) and detectable plasma HIV viral load (>1,000 copies/mL; OR = 1.43; 95% CI, 1.01–2.03). Longer antiretroviral therapy duration (≥2 years) at baseline had lower odds of p16 expression (OR = 0.46; 95% CI, 0.24–0.87) than <2 years of antiretroviral therapy. Fifty-one women had CIN2+ recurrence over 2-years, of whom 33 (65%) were p16-positive at baseline. p16 was not associated with CIN2+ recurrence (Hazard Ratio = 1.35; 95% CI, 0.76–2.40).ConclusionIn this population of women with HIV and CIN2+, 41% of lesions were p16 negative and baseline p16 expression did not predict recurrence of cervical neoplasia during two-year follow up. |
| first_indexed | 2024-03-11T19:07:20Z |
| format | Article |
| id | doaj.art-891b67da8e8f43cba2cb187b9bb92b96 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-11T19:07:20Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-891b67da8e8f43cba2cb187b9bb92b962023-10-10T06:25:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-10-011010.3389/fmed.2023.12774801277480P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIVDaniel Maina0Michael H. Chung1Marleen Temmerman2Zahir Moloo3Jonathan Wawire4Sharon A. Greene5Elizabeth R. Unger6Nelly Mugo7Samah Sakr8Shahin Sayed9Christine J. McGrath10Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, KenyaDivision of Infectious Diseases, Department of Medicine Emory University, Atlanta, GA, United StatesDepartment of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, KenyaDepartment of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, KenyaDepartment of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, KenyaDepartment of Global Health, University of Washington, Seattle, WA, United StatesCenters for Disease Control and Prevention, Atlanta, GA, United StatesSexual Reproductive and Adolescent Child Health Research Program, Kenya Medical Research Institute, Nairobi, KenyaCoptic Hospital, Nairobi, KenyaDepartment of Pathology and Laboratory Medicine, Aga Khan University Hospital, Nairobi, KenyaDepartment of Global Health, University of Washington, Seattle, WA, United StatesBackgroundThe expression of p16 protein, a surrogate marker for high-risk human papillomavirus (hrHPV), is associated with cervical dysplasia. We evaluated correlates of p16 expression at treatment for high-grade cervical lesions and its utility in predicting the recurrence of cervical intraepithelial lesions grade 2 or higher (CIN2+) following cryotherapy among women with HIV.MethodsThis is a subgroup analysis of women with HIV in Kenya with baseline cervical biopsy-confirmed CIN2+ who were randomized to receive cryotherapy and followed every six-months for two-years for biopsy-confirmed recurrence of CIN2+. P16 immunohistochemistry was performed on the baseline cervical biopsy with a positive result defined as strong abnormal nuclear expression in a continuous block segment of cells (at least 10–20 cells).ResultsAmong the 200 women with CIN2+ randomized to cryotherapy, 160 (80%) had a baseline cervical biopsy specimen available, of whom 94 (59%) were p16-positive. p16 expression at baseline was associated with presence of any one of 14 hrHPV genotypes [Odds Ratio (OR) = 3.2; 95% Confidence Interval (CI), 1.03–9.78], multiple lifetime sexual partners (OR = 1.6; 95% CI, 1.03–2.54) and detectable plasma HIV viral load (>1,000 copies/mL; OR = 1.43; 95% CI, 1.01–2.03). Longer antiretroviral therapy duration (≥2 years) at baseline had lower odds of p16 expression (OR = 0.46; 95% CI, 0.24–0.87) than <2 years of antiretroviral therapy. Fifty-one women had CIN2+ recurrence over 2-years, of whom 33 (65%) were p16-positive at baseline. p16 was not associated with CIN2+ recurrence (Hazard Ratio = 1.35; 95% CI, 0.76–2.40).ConclusionIn this population of women with HIV and CIN2+, 41% of lesions were p16 negative and baseline p16 expression did not predict recurrence of cervical neoplasia during two-year follow up.https://www.frontiersin.org/articles/10.3389/fmed.2023.1277480/fullCIN2+p16recurrencecryotherapyHIVcervical cancer |
| spellingShingle | Daniel Maina Michael H. Chung Marleen Temmerman Zahir Moloo Jonathan Wawire Sharon A. Greene Elizabeth R. Unger Nelly Mugo Samah Sakr Shahin Sayed Christine J. McGrath P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV Frontiers in Medicine CIN2+ p16 recurrence cryotherapy HIV cervical cancer |
| title | P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV |
| title_full | P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV |
| title_fullStr | P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV |
| title_full_unstemmed | P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV |
| title_short | P16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with HIV |
| title_sort | p16 expression and recurrent cervical intraepithelial neoplasia after cryotherapy among women living with hiv |
| topic | CIN2+ p16 recurrence cryotherapy HIV cervical cancer |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1277480/full |
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