title: Prevalence and persistence of cervical human papillomavirus infection in HIV-positive women initiating highly active antiretroviral therapy.
abstract: OBJECTIVE
  To determine the prevalence of human papillomavirus (HPV) DNA in cervical specimens from treatment-naive women initiating highly active antiretroviral therapy (HAART) and explore the longitudinal association of HPV DNA with CD4 count and HIV viral load (VL).
  
  
  METHODS
  Women enrolled before HAART were evaluated at baseline, weeks 24, 48, and 96 with CD4 count, VL, and cervical swab for HPV DNA.
  
  
  RESULTS
  The 146 subjects had a median CD4 count of 238 cells per microliter and VL of 13,894 copies per milliliter. Ninety-seven subjects (66%) had HPV DNA detected in the baseline specimen including 90 subjects (62%) positive for 1 or more high-risk HPV types. HPV DNA detection declined to 49% at week 96 and that of a high risk HPV type to 39%. The duration of follow-up was associated with decreased detection of HPV DNA of any type (P = 0.045) and of high-risk HPV types (P = 0.003). There was at most a marginal association between HAART response and loss of detection of cervical HPV DNA.
  
  
  CONCLUSIONS
  Women initiating HAART had a high prevalence of cervical HPV DNA that declined over 96 weeks of HAART. The relationship of CD4 count and VL response to the decline of cervical HPV DNA was not strong.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202-5124, USA. kfife@iupui.edu
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Fife
authors.forename: Julia W
authors.initials: JW
authors.lastname: Wu
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Squires
authors.forename: D Heather
authors.initials: DH
authors.lastname: Watts
authors.forename: Janet W
authors.initials: JW
authors.lastname: Andersen
authors.forename: Darron R
authors.initials: DR
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000276:immunology; D015995:Prevalence; D014626:Vaginal Smears; D019562:Viral Load; D055815:Young Adult