Human papillomavirus (HPV) detection among human immunodeficiency virus-infected pregnant Thai women: implications for future HPV immunization.
BACKGROUND
Human immunodeficiency virus (HIV)-infected women are at increased risk for developing cervical cancer and for infection with human papillomavirus (HPV). Prophylactic vaccines targeting HPV types 16 and 18 are being evaluated for efficacy among young women.


OBJECTIVE
The goal was to assess the prevalence of HPV among HIV-infected pregnant women in Bangkok and to evaluate the need for prophylactic HPV vaccines studies in this population.


METHODS
The study population consisted of 256 HIV-infected pregnant women who participated in a mother-to-child HIV transmission trial. Stored cervicovaginal lavage samples were tested for the presence of HPV DNA by polymerase chain reaction with PGMY09/11 primers and reverse line-blot hybridization for determination of anogenital HPV types.


RESULTS
HPV prevalence was 35.5% (91/256); high-risk HPV prevalence was 23.4% (60/256). HPV type 16 or 18 was present in 8.2% (21/256). Almost half of all infections were multiple. Furthermore, overall HPV detection was associated with abnormal cervical cytology (P<0.001) and higher HIV-plasma viral load (P=0.007).


CONCLUSIONS
Only one-quarter of HIV-infected pregnant women in Bangkok had high-risk HPV types; less than 10% had HPV types 16 or 18. As the HPV prevalence is expected to increase during HIV disease, prophylactic vaccines targeting HPV types 16 and 18 should be studied among HIV-infected women not yet infected with these HPV types and not previously exposed.
Bollen
Liesbeth J M
LJ
Thailand MOPH-US CDC Collaboration, Nonthaburi, Rajavithi Hospital, Bangkok, Thailand, and Columbia University, New York, New York, USA. Lbollen@tuc.or.th
Chuachoowong
Rutt
R
Kilmarx
Peter H
PH
Mock
Philip A
PA
Culnane
Mary
M
Skunodom
Natapakwa
N
Chaowanachan
Thanyanan
T
Jetswang
Bongkoch
B
Neeyapun
Kanchana
K
Asavapiriyanont
Suvanna
S
Roongpisuthipong
Anuvat
A
Wright
Thomas C
TC
Tappero
Jordan W
JW
D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections; D006801:Humans; D007114:Immunization; D027383:Papillomaviridae / Q000145:classification / Q000276:immunology / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D013785:Thailand / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears; D014765:Viral Vaccines
D014765:Viral Vaccines