title: Determinants of newly detected human papillomavirus infection in HIV-infected and HIV-uninfected injection drug using women.
abstract: BACKGROUND
  We sought to identify factors associated with newly detected human papillomavirus (HPV) infection in a high-risk cohort of injection drug using women in Baltimore, MD.
  
  
  METHODS
  We studied 146 HIV-infected and 73 HIV-uninfected female participants in a 5-year prospective HIV natural history study. We examined the association of sexual and nonsexual risk factors and newly detected type-specific HPV infection as determined by consensus PCR between consecutive visits.
  
  
  RESULTS
  Newly detected HPV was more common among HIV-infected versus HIV-uninfected women (30% and 6%, respectively; P <0.01). Among the entire cohort, recent crack use (OR, 1.7; 95% CI, 1.1-2.6) and HIV infection/CD4 cell count were independent predictors for new HPV detection (HIV-uninfected as reference, OR, 4.6; 95% CI, 2.3-8.9, OR, 5.4; 95% CI, 2.8-10.3, and OR, 10.9; 95% CI, 5.5-21.7 for HIV-infected CD4 >500, 200-500, and <200, respectively). Among HIV-uninfected women, recent marijuana use was an independent predictor of newly detected HPV infection (OR, 3.5; 95% CI, 1.3-9.5).
  
  
  CONCLUSIONS
  Newly detected HPV clearly increased with greater immunosuppression in HIV-infected injection drug users. Larger studies of HIV-uninfected and infected high-risk individuals are needed to clarify the independent associations of crack and marijuana use with new (or reactivated) HPV infection.
authors.affiliation: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Darcy F
authors.initials: DF
authors.lastname: Phelan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gange
authors.forename: Linda
authors.initials: L
authors.lastname: Ahdieh-Grant
authors.forename: Shruti H
authors.initials: SH
authors.lastname: Mehta
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Kirk
authors.forename: Keerti
authors.initials: K
authors.lastname: Shah
authors.forename: Patti
authors.initials: P
authors.lastname: Gravitt
mesh_terms: D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D002188:Cannabis; D015331:Cohort Studies; D016578:Crack Cocaine; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D011446:Prospective Studies; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D014412:Tumor Virus Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology
chemical_list: D016578:Crack Cocaine