title: Increased risk of HIV acquisition among Kenyan men with human papillomavirus infection.
abstract: 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.
authors.affiliation: Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA. JenniferS@unc.edu
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.forename: Stephen
authors.initials: S
authors.lastname: Moses
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hudgens
authors.forename: Corette B
authors.initials: CB
authors.lastname: Parker
authors.forename: Kawango
authors.initials: K
authors.lastname: Agot
authors.forename: Ian
authors.initials: I
authors.lastname: Maclean
authors.forename: Jeckoniah O
authors.initials: JO
authors.lastname: Ndinya-Achola
authors.forename: Peter J F
authors.initials: PJ
authors.lastname: Snijders
authors.forename: Chris J L M
authors.initials: CJ
authors.lastname: Meijer
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bailey
mesh_terms: 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
chemical_list: D000914:Antibodies, Viral