Prevalence and persistence of cervical human papillomavirus infection in HIV-positive women initiating highly active antiretroviral therapy.

TitlePrevalence and persistence of cervical human papillomavirus infection in HIV-positive women initiating highly active antiretroviral therapy.
Publication TypeJournal Article
Year of Publication2009
AuthorsFife KH, Wu JW, Squires KE, D Watts H, Andersen JW, Brown DR
JournalJ Acquir Immune Defic Syndr
Volume51
Issue3
Pagination274-82
Date Published2009 Jul 1
ISSN1525-4135
KeywordsAdolescent, Adult, Aged, Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Cervix Uteri, Female, Follow-Up Studies, HIV Infections, HIV-1, Humans, Longitudinal Studies, Middle Aged, Papillomavirus Infections, Prevalence, Vaginal Smears, Viral Load, Young Adult
Abstract

OBJECTIVE: To determine the prevalence of human papillomavirus (HPV) DNA in cervical specimens from treatment-naive women initiating highly active antiretroviral therapy (HAART) and explore the longitudinal association of HPV DNA with CD4 count and HIV viral load (VL).

METHODS: Women enrolled before HAART were evaluated at baseline, weeks 24, 48, and 96 with CD4 count, VL, and cervical swab for HPV DNA.

RESULTS: The 146 subjects had a median CD4 count of 238 cells per microliter and VL of 13,894 copies per milliliter. Ninety-seven subjects (66%) had HPV DNA detected in the baseline specimen including 90 subjects (62%) positive for 1 or more high-risk HPV types. HPV DNA detection declined to 49% at week 96 and that of a high risk HPV type to 39%. The duration of follow-up was associated with decreased detection of HPV DNA of any type (P = 0.045) and of high-risk HPV types (P = 0.003). There was at most a marginal association between HAART response and loss of detection of cervical HPV DNA.

CONCLUSIONS: Women initiating HAART had a high prevalence of cervical HPV DNA that declined over 96 weeks of HAART. The relationship of CD4 count and VL response to the decline of cervical HPV DNA was not strong.

DOI10.1097/QAI.0b013e3181a97be5
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID19387354
PubMed Central IDPMC2742168
Grant ListAI 069434 / AI / NIAID NIH HHS / United States
AI 69471 / AI / NIAID NIH HHS / United States
AI027767 / AI / NIAID NIH HHS / United States
AI060354 / AI / NIAID NIH HHS / United States
AI069439 / AI / NIAID NIH HHS / United States
AI069452-01 / AI / NIAID NIH HHS / United States
AI069470 / AI / NIAID NIH HHS / United States
AI069472 / AI / NIAID NIH HHS / United States
AI069477 / AI / NIAID NIH HHS / United States
AI069495 / AI / NIAID NIH HHS / United States
AI069501 / AI / NIAID NIH HHS / United States
AI069532 / AI / NIAID NIH HHS / United States
AI25859 / AI / NIAID NIH HHS / United States
AI27664 / AI / NIAID NIH HHS / United States
AI27673 / AI / NIAID NIH HHS / United States
AI34853 / AI / NIAID NIH HHS / United States
AI38558 / AI / NIAID NIH HHS / United States
AI38855 / AI / NIAID NIH HHS / United States
AI46370 / AI / NIAID NIH HHS / United States
AI46381 / AI / NIAID NIH HHS / United States
AI50410 / AI / NIAID NIH HHS / United States
AI68634 / AI / NIAID NIH HHS / United States
AI68636 / AI / NIAID NIH HHS / United States
AI69411 / AI / NIAID NIH HHS / United States
AI69423-01 / AI / NIAID NIH HHS / United States
AI69494 / AI / NIAID NIH HHS / United States
AI69684 / AI / NIAID NIH HHS / United States
HD33345 / HD / NICHD NIH HHS / United States
M01 RR000750-250289 / RR / NCRR NIH HHS / United States
RR-00032 / RR / NCRR NIH HHS / United States
RR000043 / RR / NCRR NIH HHS / United States
RR00044 / RR / NCRR NIH HHS / United States
RR00046 / RR / NCRR NIH HHS / United States
RR000750 / RR / NCRR NIH HHS / United States
RR00096 / RR / NCRR NIH HHS / United States
U01 AI025859-18 / AI / NIAID NIH HHS / United States
U01 AI027673 / AI / NIAID NIH HHS / United States
U01 AI027673-18 / AI / NIAID NIH HHS / United States
U01 AI068634 / AI / NIAID NIH HHS / United States
U01 AI068634-03 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
U01 AI068636-03 / AI / NIAID NIH HHS / United States