title: Factors associated with increased prevalence of human papillomavirus infection in a cohort of HIV-infected Brazilian women.
abstract: OBJECTIVE
  Human papillomavirus (HPV) infection is a major risk factor for cervical disease. Using baseline data from the HIV-infected cohort of Evandro Chagas Clinical Research Institute at Fiocruz, Rio de Janeiro, Brazil, factors associated with an increased prevalence of HPV were assessed.
  
  
  METHODS
  Samples from 634 HIV-infected women were tested for the presence of HPV infection using hybrid capture II and polymerase chain reaction. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance.
  
  
  RESULTS
  The overall prevalence of HPV infection was 48%, of which 94% were infected with a high-risk HPV. In multivariate analysis, factors independently associated with infection with high-risk HPV type were: younger age (<30 years of age; PR 1.5, 95% confidence interval (CI) 1.1-2.1), current or prior drug use (PR 1.3, 95% CI 1.0-1.6), self-reported history of HPV infection (PR 1.2, 95% CI 0.96-1.6), condom use in the last sexual intercourse (PR 1.3, 95% CI 1.1-1.7), and nadir CD4+ T-cell count <100cells/mm(3) (PR 1.6, 95% CI 1.2-2.1).
  
  
  CONCLUSIONS
  The estimated prevalence of high-risk HPV-infection among HIV-infected women from Rio de Janeiro, Brazil, was high. Close monitoring of HPV-related effects is warranted in all HIV-infected women, in particular those of younger age and advanced immunosuppression.
authors.affiliation: Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. gbeatriz@ipec.fiocruz.br
authors.forename: Beatriz
authors.initials: B
authors.lastname: Grinsztejn
authors.forename: Valdilea Gonçalves
authors.initials: VG
authors.lastname: Veloso
authors.forename: José Eduardo
authors.initials: JE
authors.lastname: Levi
authors.forename: Luciane
authors.initials: L
authors.lastname: Velasque
authors.forename: Paula Mendes
authors.initials: PM
authors.lastname: Luz
authors.forename: Ruth Khalili
authors.initials: RK
authors.lastname: Friedman
authors.forename: Angela Cristina
authors.initials: AC
authors.lastname: Andrade
authors.forename: Ronaldo Ismerio
authors.initials: RI
authors.lastname: Moreira
authors.forename: Fabio
authors.initials: F
authors.lastname: Russomano
authors.forename: José Henrique
authors.initials: JH
authors.lastname: Pilotto
authors.forename: Francisco Inacio
authors.initials: FI
authors.lastname: Bastos
authors.forename: Joel
authors.initials: J
authors.lastname: Palefsky
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D006801:Humans; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult