title: Cervical HPV infection in Romanian women infected with HIV during early childhood.
abstract: Human papillomavirus (HPV) is the most common cause of cervical cancer worldwide, and Romania has the highest rate of cervical cancer in Europe. Sixty-five young Romanian women infected with HIV during early childhood and 25 control subjects were evaluated for the presence of cervical HPV infection and for cytologic abnormalities. HPV infection was evaluated longitudinally in 42 HIV-infected individuals. Overall 28/65 (43.1%) of HIV-infected and 8/25 (32.0%) of uninfected subjects were infected with HPV, and 21/65 (32.3%) and 6/25 (24%) had high-risk subtypes, respectively. In HIV-infected women, those maintaining or acquiring a new subtype in follow-up were more likely to have a lower nadir (p = 0.04) and current (p = 0.01) CD4 cell counts. The incidence rate for HPV acquisition events was 0.69 per subject per year, and 0.52 for high-risk subtypes. In the HIV-infected group, 9/13 (69.2%) individuals with abnormal cytology progressed at follow-up. Although HPV prevalence was similar to controls, the rate of Pap smear abnormalities was much higher, possibly due to the decreased ability to mount new immune responses. Given the high rate of incident detection of vaccine preventable strains and cytologic progression in this cohort, HPV vaccination may be beneficial at any age in co-infected women.
authors.affiliation: Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
authors.forename: Luminita
authors.initials: L
authors.lastname: Ene
authors.affiliation: Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
authors.forename: Cristina
authors.initials: C
authors.lastname: Voinea
authors.affiliation: Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
authors.forename: Claudia
authors.initials: C
authors.lastname: Stefanescu
authors.affiliation: Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania.
authors.forename: Diana
authors.initials: D
authors.lastname: Sima
authors.affiliation: Department of Infectious Diseases, "Dr.Victor Babes" Hospital for Infectious and Tropical Diseases, Bucharest, Romania School of Medicine, "Titu Maiorescu" University, Bucharest, Romania.
authors.forename: Dan
authors.initials: D
authors.lastname: Duiculescu
authors.affiliation: Department of Medicine, San Diego Veterans Affairs Medical Center, CA, USA Department of Medicine, University of California San Diego, CA, USA srmehta@ucsd.edu.
authors.forename: Sanjay R
authors.initials: SR
authors.lastname: Mehta
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000821:virology; D060085:Coinfection / Q000453:epidemiology*; D055088:Early Detection of Cancer; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012111:Residence Characteristics; D012383:Romania / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D014626:Vaginal Smears; D055815:Young Adult
keywords: HIV; HPV; Human papilloma virus; Romania; cervical dysplasia; vaccination; women