Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India.
Several studies in recent years have documented the genotype-specific prevalence of HPV infection and wide diversity and multiplicity of HPV genotypes among HIV-seropositive women. Yet, information on changes in HPV genotype-specific incidence and clearance rates over time, and their correlation with clinical or immunologic factors among HIV-seropositive women is scarce.



We conducted a prospective study to investigate the incidence and clearance rates of cervical HPV genotypes among HIV-seropositive women in India and expand the evidence base in this area of research.



Cervical samples were collected from n=215 HIV-seropositive women in Pune, India who underwent two screening visits separated by a median of 11-months (interquartile range: 8-18 months). HPV genotypes were determined by Roche Linear Array HPV assay. Individual genotype-specific and carcinogenicity-grouping-specific HPV incidence and clearance rates were calculated and the associations between incidence/clearance and age and HIV-related metrics were explored.



Incidence and clearance rates for 'any HPV' and 'carcinogenic HPV' genotypes were 11.1 and 18.3, and 6.7 and 33.8, per 100 person-years, respectively. Incidence and clearance rates for HPV genotypes of alpha-9 species (HPV16, HPV31, HPV33, HPV35, HPV52 and HPV58) and alpha-7 species (HPV18, HPV39, HPV45, HPV59 and HPV68) were 5.8 and 2.04, and 32.1 and 53.5, per 100 person-years, respectively. Clearance of any HPV type was associated with increasing age of participants (odds ratio: 1.08, 95%CI: 1.004-1.17), although the association marginally lost its statistical significance when adjusted for CD4 counts and antiretroviral therapy status.



Genotype-specific clearance rates of HPV were higher than corresponding incidence rates. The suggestion of a positive associations of increasing age with HPV clearance points to the need for etiologic studies on age-related hormonal changes on clearance of cervical HPV infection.
National AIDS Research Institute, Pune, India.
Arati
A
Mane
National Cancer Institute, Rockville, USA. Electronic address: vikrant.sahasrabuddhe@nih.gov.
Vikrant V
VV
Sahasrabuddhe
National AIDS Research Institute, Pune, India.
Amit
A
Nirmalkar
National AIDS Research Institute, Pune, India.
Arun R
AR
Risbud
National AIDS Research Institute, Pune, India.
Seema
S
Sahay
Byramjee Jeejeebhoy Government Medical College, Pune, India.
Ramesh A
RA
Bhosale
Vanderbilt University School of Medicine, Nashville, USA.
Sten H
SH
Vermund
National Institute of Epidemiology, Chennai, India.
Sanjay M
SM
Mehendale
D000328:Adult; D002584:Cervix Uteri / Q000821:virology*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology*; D011446:Prospective Studies
Clearance; Genotypes; HIV; HPV; Incidence; Natural history