title: Time trend analysis of cervical high-risk human papillomavirus (HPV) in HIV-infected women in an urban cohort from Rio de Janeiro, Brazil: the rise of non-16/18 HPV.
abstract: OBJECTIVE
  HIV-infected women are at increased risk of human papillomavirus (HPV) infection. Time trends in annual prevalences of cervical high-risk human papillomavirus (HR-HPV) genotypes among a non-vaccinated, HIV-infected female cohort in urban Brazil were assessed for the period 2006-2012.
  
  
  METHODS
  Cervical specimens were collected for HPV genotyping yearly between January 2006 and December 2012 in a cross-sectional analysis of participants aged ≥18 years enrolled in the Women's HIV Cohort at Fiocruz in Rio de Janeiro, Brazil. Age-adjusted generalized estimating equation models with an exchangeable matrix were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for annual HPV positivity (reference year: 2006).
  
  
  RESULTS
  Among the 590 participants, the median age across all study years ranged from 35.5 to 40.0 years. The prevalence of any HR-HPV was ≥53% every year; prevalences of HR-HPV 16, 58, 59, and 68 were ≥24% in at least 1 year. The odds of HPV 16 and 68 decreased in 2012. HPV 58 prevalence followed a U-shape, beginning and ending at >20%. HPV 59 prevalence followed a linear trend, with increased odds in 2012 (OR 16.0, 95% CI 3.8-67.3; Bonferroni-adjusted p-value <0.01).
  
  
  CONCLUSIONS
  The prevalences of HR-HPV 58, 59, and 68 were high in this cohort. Given current HR-HPV vaccine coverage and availability, further investigations are needed to optimize vaccine recommendations for this population.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Program in Global Health, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA 90095, USA; Department of Internal Medicine, Montefiore University Hospital of Albert Einstein College of Medicine, Bronx, New York, USA. Electronic address: mcambou@montefiore.org.
authors.forename: Mary C
authors.initials: MC
authors.lastname: Cambou
authors.affiliation: Virology Laboratory, Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: José Eduardo
authors.initials: JE
authors.lastname: Levi
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Program in Global Health, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, CHS 37-121, Los Angeles, CA 90095, USA.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Angela
authors.initials: A
authors.lastname: de Andrade
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Emilia M
authors.initials: EM
authors.lastname: Jalil
authors.affiliation: Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Fabio
authors.initials: F
authors.lastname: Russomano
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Mônica
authors.initials: M
authors.lastname: Derrico
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Valdilea G
authors.initials: VG
authors.lastname: Veloso
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Ruth K
authors.initials: RK
authors.lastname: Friedman
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Paula M
authors.initials: PM
authors.lastname: Luz
authors.affiliation: Instituto Nacional de Infectologia Evandro Chagas (IPEC), Fundação Oswaldo Cruz, Fiocruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Grinsztejn
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D014505:Urban Population
keywords: Cervical HPV; Epidemiology; HIV; HPV vaccine; High-risk HPV; Women