Increased risk of HIV acquisition among Kenyan men with human papillomavirus infection.
BACKGROUND
Few data on the effect of human papillomavirus (HPV) infection on human immunodeficiency virus (HIV) acquisition are available.


METHODS
HIV-seronegative, sexually active, 18-24-year-old Kenyan men participating in a randomized trial of male circumcision provided exfoliated penile cells from 2 anatomical sites (glans/coronal sulcus and shaft) at baseline. The GP5+/6+ polymerase chain reaction assay ascertained a wide range of HPV DNA types at the baseline visit. The risk of HIV infection was estimated using Kaplan-Meier methods and hazard ratios from proportional hazards models.


RESULTS
Of 2168 uncircumcised men with baseline HPV data, 1089 (50%) were positive for HPV DNA. The cumulative incidence of HIV infection by 42 months was 5.8% (95% confidence interval [CI], 3.6%-7.9%) among men with HPV-positive glans/coronal sulcus specimens, versus 3.7% [95% CI, 1.8%-5.6%] among men with HPV-negative glans/coronal sulcus specimens (P = .01). Controlling for subsequent circumcision status, baseline herpes simplex virus type 2 serostatus, and sexual and sociodemographic risk factors, the hazard ratio for HIV infection among men with HPV-positive glans/coronal sulcus specimens was 1.8 (95% CI, 1.1-2.9), compared with men with HPV-negative glans/coronal sulcus specimens.


CONCLUSIONS
The results suggest an independent increased risk of HIV seroconversion among HPV-positive men. If this finding is confirmed in other studies, HPV prevention could be another tool for HIV prevention.
Smith
Jennifer S
JS
Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA. JenniferS@unc.edu
Moses
Stephen
S
Hudgens
Michael G
MG
Parker
Corette B
CB
Agot
Kawango
K
Maclean
Ian
I
Ndinya-Achola
Jeckoniah O
JO
Snijders
Peter J F
PJ
Meijer
Chris J L M
CJ
Bailey
Robert C
RC
D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D002944:Circumcision, Male; D015897:Comorbidity; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008297:Male; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology*; D016133:Polymerase Chain Reaction / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult
D000914:Antibodies, Viral