Increased alpha-9 human papillomavirus species viral load in human immunodeficiency virus positive women.
BACKGROUND
Persistent high-risk (HR) human papillomavirus (HPV) infection and increased HR-HPV viral load are associated with the development of cancer. This study investigated the effect of human immunodeficiency virus (HIV) co-infection, HIV viral load and CD4 count on the HR-HPV viral load; and also investigated the predictors of cervical abnormalities.


METHODS
Participants were 292 HIV-negative and 258 HIV-positive women. HR-HPV viral loads in cervical cells were determined by the real-time polymerase chain reaction.


RESULTS
HIV-positive women had a significantly higher viral load for combined alpha-9 HPV species compared to HIV-negative women (median 3.9 copies per cell compared to 0.63 copies per cell, P = 0.022). This was not observed for individual HPV types. HIV-positive women with CD4 counts >350/μl had significantly lower viral loads for alpha-7 HPV species (median 0.12 copies per cell) than HIV-positive women with CD4 ≤350/μl (median 1.52 copies per cell, P = 0.008), but low CD4 count was not significantly associated with increased viral load for other HPV species. High viral loads for alpha-6, alpha-7 and alpha-9 HPV species were significant predictors of abnormal cytology in women.


CONCLUSIONS
HIV co-infection significantly increased the combined alpha-9 HPV viral load in women but not viral loads for individual HPV types. High HR-HPV viral load was associated with cervical abnormal cytology.
Zizipho Z A
ZZ
Mbulawa
Leigh F
LF
Johnson
Dianne J
DJ
Marais
Inger
I
Gustavsson
Jennifer R
JR
Moodley
David
D
Coetzee
Ulf
U
Gyllensten
Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Road, Observatory, 7925 Cape Town, South Africa. Anna-Lise.Williamson@uct.ac.za.
Anna-Lise
AL
Williamson
D000328:Adult; D018791:CD4 Lymphocyte Count; D060085:Coinfection / Q000276:immunology / Q000821:virology*; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology*; D030361:Papillomavirus Infections / Q000276:immunology / Q000821:virology*; D012307:Risk Factors; D019562:Viral Load