title: The impact of HIV status and type on the clearance of human papillomavirus infection among Senegalese women.
abstract: BACKGROUND
  Persistent infection with human papillomavirus (HPV) is associated with the development and progression of HPV-related disease, including cervical intraepithelial neoplasia (CIN) and invasive cervical cancer.
  
  
  METHODS
  We examined the impact of human immunodeficiency virus (HIV) status and type on the clearance of HPV infection among 614 Senegalese women enrolled in a longitudinal study of HPV and CIN. Women were examined every 4 months for HPV DNA. Clearance was defined as 2 consecutive negative HPV DNA test results.
  
  
  RESULTS
  Cox proportional hazard regression with time-dependent covariates indicated that HIV-positive women were less likely to clear HPV infection (adjusted hazard ratio [HR], 0.31 [95% confidence interval {CI}, 0.21-0.45]) than HIV-negative women. Among HIV-positive women, those with CD4 cell counts <200 or from 200 to 500 cells/microL showed a 71% (adjusted HR, 0.29 [95% CI, 0.11-0.76]) and 32% (adjusted HR, 0.68 [95% CI, 0.31-1.48]) reduction in the likelihood of HPV clearance, respectively, compared with those with CD4 cell counts >500 cells/microL. HIV-2 infection was associated with an increased likelihood of HPV clearance (adjusted HR, 2.46 [95% CI, 1.17-5.16]), compared with that for HIV-1 infection.
  
  
  CONCLUSIONS
  HIV infection reduces the likelihood of HPV clearance. Among HIV-positive women, immunosuppression, as measured by CD4 cell count, reduces the likelihood of HPV clearance, and HIV type appears to be associated with HPV clearance.
authors: Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98103, USA.
authors: Ali
authors: A
authors: Rowhani-Rahbar
authors: Stephen E
authors: SE
authors: Hawes
authors: Papa Salif
authors: PS
authors: Sow
authors: Papa
authors: P
authors: Toure
authors: Qinghua
authors: Q
authors: Feng
authors: Ahmadou
authors: A
authors: Dem
authors: Birama
authors: B
authors: Dembele
authors: Cathy W
authors: CW
authors: Critchlow
authors: Ibraham
authors: I
authors: N'Doye
authors: Nancy B
authors: NB
authors: Kiviat
mesh_terms: D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000145:classification / Q000302:isolation & purification*; D015498:HIV-2 / Q000145:classification / Q000302:isolation & purification*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000276:immunology* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000276:immunology*; D012675:Senegal; D014930:Women
chemical_list: D004279:DNA, Viral