title: Influence of HIV-1 and/or HIV-2 infection and CD4 count on cervical HPV DNA detection in women from Senegal, West Africa.
abstract: BACKGROUND
  HIV infection is associated with greater risk of precancerous lesions and cervical cancer in women. However, several factors remain unclarified regarding the association between HIV infection and HPV detection, especially among those with HIV type 2 versus type 1 infection and severely immunocompromised persons.
  
  
  OBJECTIVE
  To evaluate HPV overall and type-specific detection among HIV-infected and uninfected women in Senegal.
  
  
  METHODS
  Detection of HPV DNA for 38 genotypes in cervical swabs using PCR-based methods was evaluated in HIV-positive (n=467) and HIV-negative (n=2139) women participating in studies in Senegal. Among HIV-1 and/or HIV-2 positive women, CD4 counts were assessed. Adjusted multivariable prevalence ratios (PR) were calculated.
  
  
  RESULTS
  The prevalence of any HPV DNA and multiple HPV types was greater among HIV-infected individuals (78.2% and 62.3%, respectively) compared with HIV-negative women (27.1% and 11.6%). This trend was also seen for HPV types 16 and 18 (13.1% and 10.9%) compared to HIV-negative women (2.2% and 1.7%). HIV-infected women with CD4 cell counts less than 200 cells/μl had a higher likelihood of any HPV detection (PRa 1.30; 95% CI 1.07-1.59), multiple HPV types (PRa 1.52; 95% CI 1.14-2.01), and HPV-16 (PRa 9.00; 95% CI 1.66-48.67), but not HPV-18 (PRa 1.20, 95% CI 0.45-3.24) compared to those with CD4 counts 500 cells/μl or above.
  
  
  CONCLUSIONS
  HIV-infected women, especially those most severely immunocompromised, are more likely to harbor HPV. Measures to prevent initial HPV infection and subsequent development of cervical cancer through focused screening efforts should be implemented in these high risk populations.
authors.affiliation: Department of Epidemiology, School of Public Health, University of Washington, Box 357236, Seattle, WA 98195, USA; International Agency for Research on Cancer, Section of Environment and Radiation, 150 Cours Albert Thomas, Lyon, 69372 Cedex 08, France. Electronic address: hanischr@fellows.iarc.fr.
authors.forename: R A
authors.initials: RA
authors.lastname: Hanisch
authors.forename: P S
authors.initials: PS
authors.lastname: Sow
authors.forename: M
authors.initials: M
authors.lastname: Toure
authors.forename: A
authors.initials: A
authors.lastname: Dem
authors.forename: B
authors.initials: B
authors.lastname: Dembele
authors.forename: P
authors.initials: P
authors.lastname: Toure
authors.forename: R L
authors.initials: RL
authors.lastname: Winer
authors.forename: J P
authors.initials: JP
authors.lastname: Hughes
authors.forename: G S
authors.initials: GS
authors.lastname: Gottlieb
authors.forename: Q
authors.initials: Q
authors.lastname: Feng
authors.forename: N B
authors.initials: NB
authors.lastname: Kiviat
authors.forename: S E
authors.initials: SE
authors.lastname: Hawes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000821:virology*; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification; D015498:HIV-2 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000097:blood* / Q000453:epidemiology / Q000821:virology*; D012675:Senegal / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: ARV; CD4 count; CIN; DNA; HIV; HPV; HR-HPV; Human immunodeficiency virus; Human papillomavirus; Senegal; antiretroviral; cervical intraepithelial neoplasia; deoxyribonucleic acid; high-risk human papillomavirus; human immunodeficiency virus; human papillomavirus