Human papillomavirus infection and associated cervical disease in human immunodeficiency virus-infected women: effect of highly active antiretroviral therapy.
To determine the effect of highly active antiretroviral therapy (HAART) on high-risk human papillomavirus (HR-HPV) infections and related cervical lesions, the virologic and cytologic markers of HPV infection were prospectively studied in 163 human immunodeficiency virus (HIV)-infected women, including 27 untreated, 62 treated with reverse transcriptase inhibitors, and 74 treated with HAART. A high prevalence of both infections with HR-HPV types (68%) and squamous intraepithelial lesions (SILs; low grade, 20.2%; high grade, 6.2%) was observed. The risks of infection and disease were inversely correlated with CD4 cell counts (P=.015 and P=.022, respectively). During the observation period (mean, 15.4 months; range, 6-24 months), CD4 cell counts increased significantly only in subjects receiving HAART (P<.001). Persistence of HR-HPV infection and progression of SILs were comparable in the 3 groups. These results indicate that, even in the era of HAART, HIV-infected women should be monitored carefully for the emergence of high-grade SILs and cervical cancer.
Lillo
F B
FB
Laboratory of Virology, San Raffaele Hospital, 20127 Milan, Italy. lillo.flavia@hsr.it
Ferrari
D
D
Veglia
F
F
Origoni
M
M
Grasso
M A
MA
Lodini
S
S
Mastrorilli
E
E
Taccagni
G
G
Lazzarin
A
A
Uberti-Foppa
C
C
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000502:physiology; D030361:Papillomavirus Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000821:virology; D014412:Tumor Virus Infections / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000821:virology; D002577:Uterine Cervical Diseases / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology / Q000821:virology
D004279:DNA, Viral