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Cervicovaginal Human Papillomavirus Infection in Human Immunodeficiency Virus-1 (HIV)-Positive and High-Risk HIV-Negative Women

Cervicovaginal Human Papillomavirus Infection in Human Immunodeficiency Virus-1 (HIV)-Positive... AbstractBACKGROUND: Human papillomavirus (HPV) infection isassociated with precancerous cervical squamous intraepithelial lesionscommonly seen among women infected with human immunodeficiency virus-1(HIV). We characterized HPV infection in a large cohort of HIV-positiveand HIV-negative women participating in the Women's Interagency HIVStudy to determine the prevalence of and risk factors forcervicovaginal HPV infection in HIV-positive women. METHODS:HIV-positive (n = 1778) and HIV-negative (n = 500) women weretested at enrollment for the presence of HPV DNA in a cervicovaginallavage specimen. Blood samples were tested for HIV antibody status,level of CD4-positive T cells, and HIV RNA load (copies/mL). Aninterview detailing risk factors was conducted. Univariate andmultivariate analyses were performed. RESULTS: Compared withHIV-negative women, HIV-positive women with a CD4+cell countof less than 200/mm3were at the highest risk of HPVinfection, regardless of HIV RNA load (odds ratio [OR] = 10.13;95% confidence interval [CI] = 7.32-14.04), followed by womenwith a CD4+count greater than 200/mm3and an HIVRNA load greater than 20 000 copies/mL (OR = 5.78; 95% CI =4.17-8.08) and women with a CD4+count greater than200/mm3and an HIV RNA load less than 20 000copies/mL (OR = 3.12; 95% CI = 2.36-4.12), after adjustment forother factors. Other risk factors among HIV-positive women includedracial/ethnic background (African-American versus Caucasian, OR = 1.64;95% CI = 1.19-2.28), current smoking (yes versus no; OR = 1.55;95% CI = 1.20-1.99), and younger age (age <30 years versus⩾40 years; OR = 1.75; 95% CI = 1.23-2.49).CONCLUSIONS: Although the strongest risk factors of HPVinfection among HIV-positive women were indicators of more advancedHIV-related disease, other factors commonly found in studies ofHIV-negative women, including racial/ethnic background, currentsmoking, and age, were important in HIV-positive women as well. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of the National Cancer Institute Oxford University Press

Cervicovaginal Human Papillomavirus Infection in Human Immunodeficiency Virus-1 (HIV)-Positive and High-Risk HIV-Negative Women

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References (58)

Publisher
Oxford University Press
Copyright
Oxford University Press
ISSN
0027-8874
eISSN
1460-2105
DOI
10.1093/jnci/91.3.226
Publisher site
See Article on Publisher Site

Abstract

AbstractBACKGROUND: Human papillomavirus (HPV) infection isassociated with precancerous cervical squamous intraepithelial lesionscommonly seen among women infected with human immunodeficiency virus-1(HIV). We characterized HPV infection in a large cohort of HIV-positiveand HIV-negative women participating in the Women's Interagency HIVStudy to determine the prevalence of and risk factors forcervicovaginal HPV infection in HIV-positive women. METHODS:HIV-positive (n = 1778) and HIV-negative (n = 500) women weretested at enrollment for the presence of HPV DNA in a cervicovaginallavage specimen. Blood samples were tested for HIV antibody status,level of CD4-positive T cells, and HIV RNA load (copies/mL). Aninterview detailing risk factors was conducted. Univariate andmultivariate analyses were performed. RESULTS: Compared withHIV-negative women, HIV-positive women with a CD4+cell countof less than 200/mm3were at the highest risk of HPVinfection, regardless of HIV RNA load (odds ratio [OR] = 10.13;95% confidence interval [CI] = 7.32-14.04), followed by womenwith a CD4+count greater than 200/mm3and an HIVRNA load greater than 20 000 copies/mL (OR = 5.78; 95% CI =4.17-8.08) and women with a CD4+count greater than200/mm3and an HIV RNA load less than 20 000copies/mL (OR = 3.12; 95% CI = 2.36-4.12), after adjustment forother factors. Other risk factors among HIV-positive women includedracial/ethnic background (African-American versus Caucasian, OR = 1.64;95% CI = 1.19-2.28), current smoking (yes versus no; OR = 1.55;95% CI = 1.20-1.99), and younger age (age <30 years versus⩾40 years; OR = 1.75; 95% CI = 1.23-2.49).CONCLUSIONS: Although the strongest risk factors of HPVinfection among HIV-positive women were indicators of more advancedHIV-related disease, other factors commonly found in studies ofHIV-negative women, including racial/ethnic background, currentsmoking, and age, were important in HIV-positive women as well.

Journal

Journal of the National Cancer InstituteOxford University Press

Published: Feb 3, 1999

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