title: Relationship of pregnancy to human papillomavirus among human immunodeficiency virus-infected women.
abstract: OBJECTIVE
  Because parity is a reported risk factor for cervical cancer, we sought to estimate the effects of pregnancy on the prevalence, incident detection, and copy number of human papillomavirus (HPV) among human immunodeficiency virus (HIV)-infected women, patients at high risk for cervical cancer.
  
  
  METHODS
  Human immunodeficiency virus-infected women who had a pregnancy in the Women's Interagency HIV Study (n = 178) and the Women and Infants Transmission Study (n = 450) underwent serial type-specific HPV DNA testing using MY09/MY11 polymerase chain reaction. During pregnancy and during the prepregnancy and postpregnancy periods, we assessed HPV prevalence, incident detection, and HPV copy number (estimated using hybridization signal strength) of both oncogenic and nononcogenic HPV. All binary-regression analyses incorporated generalized estimating equations to address the repeated observations of the same women over time, and were further adjusted for parity, gestational age, smoking, antiretroviral use, number of lifetime sexual partners, and oral contraceptive use.
  
  
  RESULTS
  The prevalence and copy number of oncogenic and nononcogenic HPV did not significantly differ between pregnancy and either the prepregnancy or postpregnancy periods. Incident HPV detection was significantly lower for both oncogenic and nononcogenic HPV during pregnancy compared with the postpregnancy period (relative risk 0.534, 95% confidence interval 0.390-0.732, P < .001 and relative risk 0.577, 95% confidence interval 0.428-0.779, P < .001, respectively), but not compared with the prepregnancy period
  
  
  CONCLUSIONS
  Among HIV-infected women, the incident detection of HPV is lower during pregnancy compared with postpregnancy, while prevalence and copy number do no differ between pregnancy and either prepregnancy or postpregnancy.
  
  
  METHODS
  II-3.
authors.affiliation: Department of Obstetrics and Gynecology, Maimonides Medical Center and SUNY Downstate, Brooklyn, New York, USA. Hminkoff@maimonidesmed.org
authors.forename: Howard
authors.initials: H
authors.lastname: Minkoff
authors.forename: XianLin
authors.initials: X
authors.lastname: Shen
authors.forename: Lin Shen
authors.initials: LS
authors.lastname: Xian
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.forename: Robert
authors.initials: R
authors.lastname: Leighty
authors.forename: Ron
authors.initials: R
authors.lastname: Hershow
authors.forename: Joel
authors.initials: J
authors.lastname: Palefsky
authors.forename: Ruth
authors.initials: R
authors.lastname: Tuomala
authors.forename: Natalie
authors.initials: N
authors.lastname: Neu
authors.forename: Carmen D
authors.initials: CD
authors.lastname: Zorrilla
authors.forename: Mary
authors.initials: M
authors.lastname: Paul
authors.forename: Howard
authors.initials: H
authors.lastname: Strickler
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000453:epidemiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D015995:Prevalence; D012044:Regression Analysis; D012907:Smoking / Q000009:adverse effects
chemical_list: D004279:DNA, Viral