title: Variants of human papillomaviruses 16 and 18 and their natural history in human immunodeficiency virus-positive women.
abstract: Highly oncogenic human papillomavirus (HPV) 16 and 18 variants might be expected to be particularly aggressive in HIV-positive women. The association of HPV16 and 18 variant lineages with race, human immunodeficiency virus (HIV) coinfection, CD4+ T-cell count, HIV-RNA level, time-to-clearance of HPV infection and presence of squamous intraepithelial lesions (SIL) among women in the Women's Interagency HIV Study was studied. Subjects were followed semi-annually with Pap smear and cervicovaginal lavage (CVL). HPV DNA was detected in CVLs using MY09/11 L1 PCR assay. Specimens positive for HPV16/18 underwent E6 PCR and sequencing to determine the variant present. Specimens from 195 HPV16- and 162 HPV18-positive women were classified into variant lineages based on sequencing results. African variants of HPV16 and HPV18 were significantly more prevalent among African-Americans than among Caucasians [42 versus 14 % (P=0.001) and 60 versus 13 % (P<0.001), respectively]. However, it was not possible to detect associations between the HPV16 or 18 variant lineages and other factors studied. African variants of HPV16/18 were more common in women of African descent living outside Africa, which could reflect mixing behaviours and/or immunogenetic factors. However, in a large population of HIV-infected women, the variant of HPV16 or 18 was unrelated to persistence of infection or presence of SIL. If non-European variants are more oncogenic, the effect may involve a late stage in cervical tumorigenesis.
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Nicolas F
authors.initials: NF
authors.lastname: Schlecht
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Burk
authors.affiliation: University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Palefsky
authors.affiliation: Maimonides Medical Center, Brooklyn, NY, USA.
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Xue
authors.affiliation: Southern Illinois University School of Medicine, Springfield, IL, USA.
authors.forename: L Stewart
authors.initials: LS
authors.lastname: Massad
authors.affiliation: The Henry M. Jackson Foundation, Rockville, MD, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Bacon
authors.affiliation: University of Southern California, Los Angeles, CA, USA.
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Levine
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gange
authors.affiliation: National Institute of Child Health and Human Development, Bethesda, MD, USA.
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.affiliation: University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Maria M Da
authors.initials: MMD
authors.lastname: Costa
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Zigui
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Ji Yon
authors.initials: JY
authors.lastname: Bang
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Fazzari
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Hall
authors.affiliation: Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
authors.forename: Howard D
authors.initials: HD
authors.lastname: Strickler
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000821:virology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D014644:Genetic Variation; D006678:HIV / Q000235:genetics; D006679:HIV Seropositivity / Q000150:complications* / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000502:physiology; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies
chemical_list: D004279:DNA, Viral