title: Characteristics of HPV infection over time in European women who are HIV-1 positive.
abstract: OBJECTIVE
  The objectives of the study were to investigate high-risk human papillomavirus (HR-HPV) infection and type distribution in women infected with HIV-1, and to determine the relevance of HR-HPV positivity and persistence/loss to the development of high-grade cervical disease.
  
  
  METHODS
  A total of 518 European women infected with HIV attending for routine gynaecological care consented to 6-monthly follow-up visits over 3 years, with surveillance of cytology, colposcopy and histopathology, where relevant, and longer follow-up, where possible.
  
  
  METHODS
  European women infected with HIV attending for routine gynaecological care.
  
  
  METHODS
  518 European women infected with HIV attending for gynaecological care in 6 hospital-based European centres - Dublin, Edinburgh, London, Milan, Paris, and Warsaw.
  
  
  METHODS
  Cervical screening was achieved by liquid-based cytology (LBC) of brush samples in PreservCyt® medium. The HPV testing of residual samples was performed by Hybrid-Capture II, with genotyping of positives using the HPV Line Blot Assay. Histology results were accessed where available.
  
  
  METHODS
  Description of high risk human papillomavirus (HR-HPV) infection and type distribution in HIV-1 infected women.
  
  
  RESULTS
  The estimated prevalence at baseline of any HR-HPV type was 49.5% (46.3-52.8%): 10.2% for HPV 16 and 4.3% for HPV 18. The prevalence increased with increasing immunosuppression. Multiple infections were detected in 26.8%. HR-HPV genotypes were detected in 34.9% of cases with normal cytology, in 77.2% of cases with atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion (ASCUS/LSIL) and in 90.8% of cases with high-grade SIL (HSIL). The prevalence of HPV 16 in HSIL was 38.5%, with the three most common types thereafter having prevalence rates of 19.2% (HPV 58), 19.2% (HPV 53) and 16.6% (HPV 52). The overall persistence of any high-risk type was 55.8%. We found that 6 months persistence of HPV 16 occurred in 24 women. Seven cases of high-grade cervical disease developed, and all were associated with initial/persistent HR-HPV positivity.
  
  
  CONCLUSIONS
  A wide diversity of HPV types was evident, and multiple infections were common. Detection or persistence of any HR-HPV was associated with a very low incidence of subsequent high-grade disease.
authors.affiliation: HPV National Reference Centre, Pasteur Institute, Paris, France. isabelle.heard@pasteur.fr
authors.forename: I
authors.initials: I
authors.lastname: Heard
authors.forename: H A
authors.initials: HA
authors.lastname: Cubie
authors.forename: D
authors.initials: D
authors.lastname: Mesher
authors.forename: P
authors.initials: P
authors.lastname: Sasieni
mesh_terms: D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000453:epidemiology / Q000821:virology*; D018450:Disease Progression; D005060:Europe / Q000453:epidemiology; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D015497:HIV-1; D006801:Humans; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000821:virology*