title: Human papillomavirus types among women infected with HIV: a meta-analysis.
abstract: BACKGROUND
  HIV-positive women have a high prevalence of human papillomavirus (HPV) infection and are infected with a broader range of HPV types than HIV-negative women. It is not known to what extent these different types are associated with high-grade squamous intraepithelial lesions (HSIL) and cancer.
  
  
  METHODS
  Meta-analysis of HPV type-specific prevalence among HIV-positive women, stratified by geographical region and by cervical cytology: normal, atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions (ASCUS/LSIL) or HSIL.
  
  
  RESULTS
  In 20 studies, 5578 HIV-positive women were identified, largely from North America but also Africa, Asia, Europe and South/Central America. For 3230 with no cytological abnormalities, prevalence was 36.3% for any HPV and 11.9% for multiple HPV types. The six most common high-risk HPV types were 16 (4.5%), 58 (3.6%), 18 (3.1%), 52 (2.8%), 31 (2.0%) and 33 (2.0%). HPV16 was also the most common type in 2053 HIV-positive women with ASCUS/LSIL and 295 with HSIL. Those with HSIL were significantly less likely to be infected with HPV16 (odds ratio, 0.6; 95% confidence interval, 0.4-0.7) than the general female population with HSIL. In contrast, HIV-positive women with HSIL were significantly more likely to be infected with HPV types 11, 18, 33, 51, 52, 53, 58 and 61, and with multiple HPV types.
  
  
  CONCLUSIONS
  The proportion of HIV-positive women with HPV16 rose with increasing severity of cervical lesions. Nevertheless, HPV16 remained underrepresented in HIV-positive women with HSIL, who showed a higher proportion of other HPV types and multiple types compared with the general female population with HSIL.
authors.affiliation: International Agency for Research on Cancer, Lyon, France. clifford@iarc.fr
authors.forename: Gary M
authors.initials: GM
authors.lastname: Clifford
authors.forename: Maria Alice G
authors.initials: MA
authors.lastname: Gonçalves
authors.forename: Silvia
authors.initials: S
authors.lastname: Franceschi
mesh_terms: D000349:Africa / Q000453:epidemiology; D000569:Americas / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000453:epidemiology / Q000821:virology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D011230:Precancerous Conditions / Q000150:complications / Q000453:epidemiology / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000453:epidemiology / Q000821:virology