title: Prevalence and concordance of human papillomavirus infection at multiple anatomic sites among HIV-infected women from Chennai, India.
abstract: Human papillomavirus (HPV) infection at the cervix, anus and oropharynx has been rarely concurrently estimated among HIV-infected women. Using multiplex polymerase chain reaction testing, we prospectively evaluated HPV genotype distribution across three anatomic sites among 50 eligible HIV-infected women from Chennai, India, who provided biological specimens and answered a sexual behaviour questionnaire. We also assessed clinical and behavioural factors related to HPV prevalence. Oncogenic HPV prevalence was comparable between the anus and cervix at 52.2% and 52.0% and lower at the oropharynx at 13.2%; 78% of women with a cervical HPV infection had the same type in the anus. Newly acquired oncogenic HPV infections were lower at cervix (24%) than anus (35%) at three months. 'Any type' cervical HPV prevalence was higher among women with low education and less than five years since HIV diagnosis. CD4+ count and antiretroviral therapy status were not associated with HPV prevalence at the three anatomic sites; however, enrolment cervical HPV16 prevalence was elevated among women with nadir CD4+ <200 cells/µL and enrolment CD4+ <350 cells/µL. Regular cervical screening is essential in HIV-infected Indian women irrespective of CD4+ count and antiretroviral therapy status. Additional research clarifying the natural history of anal HPV infection is also needed in this population.
authors.affiliation: Division of Infectious Disease, University of South Florida, Tampa, FL, USA lmenezes@health.usf.edu.
authors.forename: Lynette J
authors.initials: LJ
authors.lastname: Menezes
authors.affiliation: YRGCARE Medical Centre, VHS, Chennai, India.
authors.forename: Selvamuthu
authors.initials: S
authors.lastname: Poongulali
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Massimo
authors.initials: M
authors.lastname: Tommasino
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Hui-Yi
authors.initials: HY
authors.lastname: Lin
authors.affiliation: YRGCARE Medical Centre, VHS, Chennai, India.
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Kate J
authors.initials: KJ
authors.lastname: Fisher
authors.affiliation: YRGCARE Medical Centre, VHS, Chennai, India.
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Saravanan
authors.affiliation: International Agency for Research on Cancer, Lyon, France.
authors.forename: Tarik
authors.initials: T
authors.lastname: Gheit
authors.affiliation: YRGCARE Medical Centre, VHS, Chennai, India.
authors.forename: Chandrasekaran
authors.initials: C
authors.lastname: Ezhilarasi
authors.affiliation: YRGCARE Medical Centre, VHS, Chennai, India.
authors.forename: Arumugham
authors.initials: A
authors.lastname: Jeeva
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Beibei
authors.initials: B
authors.lastname: Lu
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Giuliano
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000473:pathology* / Q000821:virology; D002584:Cervix Uteri / Q000473:pathology* / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D007194:India; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D009960:Oropharynx / Q000473:pathology* / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D015995:Prevalence; D011446:Prospective Studies; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D004279:DNA, Viral
keywords: AIDS; HIV infection; HPV; Human papillomavirus; anal canal; cervix; oropharynx; prevalence; sexually transmitted infection; women