Time to clearance of human papillomavirus infection by type and human immunodeficiency virus serostatus.
Persistent infection with high-risk human papillomavirus (HPV) is central to cervical carcinogenesis. Certain high-risk types, such as HPV16, may be more persistent than other HPV types, and type-specific HPV persistence may differ by HIV serostatus. This study evaluated the association between HPV type and clearance of HPV infections in 522 HIV-seropositive and 279 HIV-seronegative participants in the HIV Epidemiology Research Study (HERS, United States, 1993-2000). Type-specific HPV infections were detected using MY09/MY11/HMB01-based PCR and 26 HPV type-specific probes. The estimated duration of type-specific infections was measured from the first HPV-positive visit to the first of two consecutive negative visits. Hazard ratios (HRs) and 95% confidence intervals (CIs) for HPV clearance were calculated using Cox models adjusted for study site and risk behavior (sexual or injection drugs). A total of 1,800 HPV infections were detected in 801 women with 4.4 years median follow-up. HRs for clearance of HPV16 and related types versus low-risk HPV types were 0.79 (95% CI: 0.64-0.97) in HIV-positive women and 0.86 (95% CI: 0.59-1.27) in HIV-negative women. HRs for HPV18 versus low-risk types were 0.80 (95% CI: 0.56-1.16) and 0.57 (95% CI: 0.22-1.45) for HIV-positive and -negative women, respectively. HPV types within the high-risk category had low estimated clearance rates relative to low-risk types, but HRs were not substantially modified by HIV serostatus.
Koshiol
Jill E
JE
Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA. koshiolj@mail.nih.gov
Schroeder
Jane C
JC
Jamieson
Denise J
DJ
Marshall
Stephen W
SW
Duerr
Ann
A
Heilig
Charles M
CM
Shah
Keerti V
KV
Klein
Robert S
RS
Cu-Uvin
Susan
S
Schuman
Paula
P
Celentano
David
D
Smith
Jennifer S
JS
D000328:Adult; D005260:Female; D006678:HIV / Q000502:physiology*; D015658:HIV Infections / Q000097:blood* / Q000150:complications / Q000821:virology*; D006801:Humans; D008297:Male; D027383:Papillomaviridae / Q000502:physiology*; D030361:Papillomavirus Infections / Q000097:blood* / Q000145:classification / Q000150:complications / Q000821:virology*; D012307:Risk Factors; D013997:Time Factors