title: Prevalence, incidence, and type-specific persistence of human papillomavirus in human immunodeficiency virus (HIV)-positive and HIV-negative women.
abstract: Human immunodeficiency virus (HIV) infection and related immunosuppression are associated with excess risk for cervical neoplasia and human papillomavirus (HPV) persistence. Type-specific HPV infection was assessed at 6-month intervals for HIV-positive and HIV-negative women (median follow-up, 2.5 and 2.9 years, respectively). The type-specific incidence of HPV infection was determined, and risk factors for HPV persistence were investigated by statistical methods that accounted for repeated measurements. HIV-positive women were 1.8, 2.1, and 2.7 times more likely to have high-, intermediate-, and low-risk HPV infections, respectively, compared with HIV-negative women. In multivariate analysis, high viral signal, but not viral risk category, was independently associated with persistence among HIV-positive subjects (odds ratio [OR], 2.5; 95% confidence interval [CI], 2.1-2.9). Furthermore, persistence was 1.9 (95% CI, 1.5-2.3) times greater if the subject had a CD4 cell count <200 cells/microL (vs. >500 cells/microL). Thus, HIV infection and immunosuppression play an important role in modulating the natural history of HPV infection.
authors.affiliation: Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland 21205, USA. lahdieh@jhsph.edu
authors.forename: L
authors.initials: L
authors.lastname: Ahdieh
authors.forename: R S
authors.initials: RS
authors.lastname: Klein
authors.forename: R
authors.initials: R
authors.lastname: Burk
authors.forename: S
authors.initials: S
authors.lastname: Cu-Uvin
authors.forename: P
authors.initials: P
authors.lastname: Schuman
authors.forename: A
authors.initials: A
authors.lastname: Duerr
authors.forename: M
authors.initials: M
authors.lastname: Safaeian
authors.forename: J
authors.initials: J
authors.lastname: Astemborski
authors.forename: R
authors.initials: R
authors.lastname: Daniel
authors.forename: K
authors.initials: K
authors.lastname: Shah
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D015994:Incidence; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking; D013997:Time Factors; D014412:Tumor Virus Infections / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology