title: Frequent detection of HPV before and after initiation of antiretroviral therapy among HIV/HSV-2 co-infected women in Uganda.
abstract: OBJECTIVE
  Most data on HPV and antiretroviral therapy (ART) come from high-resource countries with infrequent sampling for HPV pre- and post-ART initiation. Therefore, we examined the frequency of cervical HPV DNA detection among HIV/HSV-2 co-infected women followed monthly for 6 months both before and after initiation of ART in Rakai, Uganda.
  
  
  METHODS
  Linear Array was used to detect 37 HPV genotypes in self-collected cervicovaginal swabs from 96 women who initiated ART. Random-effects log-binomial regression was used to compare the prevalence of HPV detection in the pre- and post-ART periods and determine other potential risk factors, including CD4 counts and HIV viral load.
  
  
  RESULTS
  Nearly all women had detectable HPV in the 6 months preceding ART initiation (92%) and the cumulative prevalence remained high following initiation of therapy (90%). We found no effect of ART on monthly HPV DNA detection (prevalence ratio: 1.0; 95% confidence interval: 0.96, 1.08), regardless of immune reconstitution or HIV viral suppression. Older age and higher pre-ART CD4 counts were associated with a significantly lower risk of HPV DNA detection.
  
  
  CONCLUSIONS
  ART did not impact HPV detection within 6 months of therapy initiation, highlighting the importance of continued and consistent screening, even after ART-initiation and immune reconstitution.
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America. arositch@jhsph.edu
authors: Anne F
authors: AF
authors: Rositch
authors: Patti E
authors: PE
authors: Gravitt
authors: Aaron A R
authors: AA
authors: Tobian
authors: Kevin
authors: K
authors: Newell
authors: Thomas C
authors: TC
authors: Quinn
authors: David
authors: D
authors: Serwadda
authors: Paschal
authors: P
authors: Ssebbowa
authors: Valerian
authors: V
authors: Kiggundu
authors: Ronald H
authors: RH
authors: Gray
authors: Steven J
authors: SJ
authors: Reynolds
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use*; D000367:Age Factors; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002584:Cervix Uteri / Q000821:virology; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D006558:Herpes Genitalis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000235:genetics; D015995:Prevalence; D012044:Regression Analysis; D014454:Uganda / Q000453:epidemiology; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D000212:Acyclovir
references: J Acquir Immune Defic Syndr. 2010 Jan;53(1):70-7
references: 20035163
references: Infect Agent Cancer. 2011 Jul 12;6(1):11
references: 21749691
references: J Natl Cancer Inst. 2005 Apr 20;97(8):577-86
references: 15840880
references: Antivir Ther. 2006;11(8):1091-6
references: 17302379
references: J Infect Dis. 2001 Sep 15;184(6):682-90
references: 11517428
references: Int J Cancer. 1998 May 18;76(4):480-6
references: 9590121
references: Lancet Infect Dis. 2012 Jun;12(6):441-8
references: 22433279
references: Biom J. 2006 Feb;48(1):5-22
references: 16544809
references: N Engl J Med. 2003 Feb 6;348(6):518-27
references: 12571259
references: JAMA. 2000 Feb 23;283(8):1031-7
references: 10697063
references: J Natl Cancer Inst. 2003 Jul 16;95(14):1062-71
references: 12865452
references: BMC Infect Dis. 2010 Oct 14;10:295
references: 20946655
references: Clin Infect Dis. 2004 Mar 1;38(5):737-42
references: 14986260
references: J Infect Dis. 2010 Mar;201(5):681-90
references: 20105077
references: Curr Opin Oncol. 2003 Sep;15(5):382-8
references: 12960521
references: J Antimicrob Chemother. 2008 Jan;61(1):191-4
references: 17977910
references: J Natl Cancer Inst. 2009 Aug 19;101(16):1120-30
references: 19648510
references: J Clin Pathol. 2002 Apr;55(4):244-65
references: 11919208
references: Am J Epidemiol. 2000 Jun 15;151(12):1148-57
references: 10905527
references: J Infect Dis. 2003 Jul 1;188(1):128-36
references: 12825181
references: Sex Transm Dis. 2011 Nov;38(11):1059-66
references: 21992985
references: J Acquir Immune Defic Syndr. 2009 Jul 1;51(3):274-82
references: 19387354
references: Cancer Epidemiol Biomarkers Prev. 2008 Jun;17(6):1300-7
references: 18559545
references: N Engl J Med. 2011 Aug 11;365(6):493-505
references: 21767103
references: Acta Biomed. 2007;78(1):36-40
references: 17687815
references: Cytokine. 2011 Dec;56(3):798-803
references: 22015106
references: Eur J Cancer Prev. 2008 Nov;17(6):545-54
references: 18941376
references: J Clin Microbiol. 2000 Jan;38(1):357-61
references: 10618116
references: Int J Epidemiol. 1997 Feb;26(1):220-3
references: 9126523
references: J Clin Microbiol. 2002 Mar;40(3):902-7
references: 11880413
references: J Infect Dis. 2001 Sep 1;184(5):547-51
references: 11494160
references: AIDS. 2002 Sep 6;16(13):1799-802
references: 12218392
references: Lancet. 2009 Apr 18;373(9672):1352-63
references: 19361855
references: Infect Agent Cancer. 2010 May 12;5:8
references: 20462441
references: J Infect Dis. 2009 Apr 1;199(7):965-73
references: 19239366
references: J Natl Cancer Inst. 2004 Jul 21;96(14):1070-6
references: 15265968
references: J Pathol. 1999 Sep;189(1):12-9
references: 10451482
references: AIDS. 2012 Aug 24;26(13):1645-52
references: 22555167