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J Infect Dis. 2011 Feb 15;203(4):479-86. doi: 10.1093/infdis/jiq083. Epub 2011 Jan 7.

Rapid rise in detection of human papillomavirus (HPV) infection soon after incident HIV infection among South African women.

Author information

1
Department of Pathology, College of Physicians and Surgeons, University of Cape Town, Cape Town, South Africa.

Abstract

BACKGROUND:

It is well established that the prevalence of human papillomavirus (HPV) infection is increased among human immunodeficiency virus (HIV)-positive individuals, but the temporal relationships between these infections are unclear.

METHODS:

During a South African cervical cancer screening trial, 5595 women 35-65 years of age were followed up for 36 months; 577 women were HIV positive at enrollment, HIV seroconversion occurred in 123 women, and 4895 women remained HIV negative throughout. Tests for high-risk HPV DNA and cytology were performed on cervical samples, and a colposcopy/biopsy was performed at each visit. The effects of early HIV infection on the risk of HPV infection and HPV-related disease were evaluated.

RESULTS:

Among seroconverters, HPV infection prevalence was 20.3% before seroconversion, 23.6% at seroconversion (P = .4), and 49.1% after seroconversion (P = .01). Seroconverters had significantly lower HPV infection prevalence than women with prevalent HIV infection before and at seroconversion (41.8% and 45.9%, respectively) but had similar HPV infection prevalence to women with prevalent HIV infection after seroconversion (49.4%). HIV seroconversion was associated with newly detected HPV infection (adjusted hazard ratio [AHR], 4.02; 95% confidence interval [CI], 2.26-7.13) and increased risk of low-grade cytological abnormalities (AHR, 2.53; 95% CI, 1.16-5.51) compared with HIV-negative women.

CONCLUSION:

Detection of HPV infection increases rapidly within the first years after HIV seroconversion, suggesting that mucosal immune dysfunction occurring at an early stage of HIV infection may influence HPV-related diseases.

PMID:
21216869
PMCID:
PMC3071227
DOI:
10.1093/infdis/jiq083
[Indexed for MEDLINE]
Free PMC Article

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