Human papillomavirus capsid antibody response to natural infection and risk of subsequent HPV infection in HIV-positive and HIV-negative women.
The association between seropositivity to virus-like particles (VLP) of human papillomavirus (HPV) types 16, 18, 31, 35, or 45 and subsequent cervical HPV infection was examined in 829 women with HIV and 413 risk-matched HIV-negative women. We found no statistically significant differences between HPV-seropositive and HPV-seronegative women in the risk of a new infection with the homologous HPV type, with the exception of a reduced risk of HPV 45 infections 4.5 years beyond the baseline serology measurement in HIV-positive women [hazard ratio, 0.21; 95% confidence interval (CI), 0.05-0.89]. Among HIV-negative women, HPV seropositivity was not associated with a statistically significant reduced risk of infections with related viruses in the HPV 16, HPV 18, or "other" HPV groups. Among HIV-positive women, HPV seropositivity was associated with a slightly increased risk of infection with group-related viruses, but the differences were only statistically significant for infection with HPV 16 group viruses (hazard ratio, 1.6; 95% CI, 1.1-2.3) in HPV 18-seropositive women and for infections with "other" HPV group viruses in HPV 31-seropositive women (hazard ratio, 1.45; 95% CI, 1.0-2.0). The lack of a protective immune effect from natural infection is most likely due to the low level of antibody elicited by natural HPV infection and/or the potential for reactivation of HPV, especially in HIV-positive women.
Viscidi
Raphael P
RP
Johns Hopkins Hospital, Blalock Room 1105, 600 North Wolfe Street, Baltimore, MD 21287, USA. rviscid1@jhem.jhmi.edu
Snyder
Brad
B
Cu-Uvin
Susan
S
Hogan
Joseph W
JW
Clayman
Barbara
B
Klein
Robert S
RS
Sobel
Jack
J
Shah
Keerti V
KV
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D002213:Capsid / Q000276:immunology; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016013:Likelihood Functions; D027383:Papillomaviridae / Q000276:immunology* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000473:pathology / Q000821:virology; D016016:Proportional Hazards Models; D018570:Risk Assessment; D016036:Seroepidemiologic Studies; D014481:United States; D014621:Vagina / Q000473:pathology / Q000821:virology; D014626:Vaginal Smears
D000914:Antibodies, Viral; D004279:DNA, Viral