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Randomized Controlled Trial
. 2010 Jun 1;201(11):1677-85.
doi: 10.1086/652408.

Increased risk of HIV acquisition among Kenyan men with human papillomavirus infection

Jennifer S Smith  1 , Stephen Moses, Michael G Hudgens, Corette B Parker, Kawango Agot, Ian Maclean, Jeckoniah O Ndinya-Achola, Peter J F Snijders, Chris J L M Meijer, Robert C Bailey
Affiliations
Randomized Controlled Trial

Increased risk of HIV acquisition among Kenyan men with human papillomavirus infection

Jennifer S Smith et al. J Infect Dis. .

Abstract

Background: Few data on the effect of human papillomavirus (HPV) infection on human immunodeficiency virus (HIV) acquisition are available.

Methods: HIV-seronegative, sexually active, 18-24-year-old Kenyan men participating in a randomized trial of male circumcision provided exfoliated penile cells from 2 anatomical sites (glans/coronal sulcus and shaft) at baseline. The GP5+/6+ polymerase chain reaction assay ascertained a wide range of HPV DNA types at the baseline visit. The risk of HIV infection was estimated using Kaplan-Meier methods and hazard ratios from proportional hazards models.

Results: Of 2168 uncircumcised men with baseline HPV data, 1089 (50%) were positive for HPV DNA. The cumulative incidence of HIV infection by 42 months was 5.8% (95% confidence interval [CI], 3.6%-7.9%) among men with HPV-positive glans/coronal sulcus specimens, versus 3.7% [95% CI, 1.8%-5.6%] among men with HPV-negative glans/coronal sulcus specimens (P = .01). Controlling for subsequent circumcision status, baseline herpes simplex virus type 2 serostatus, and sexual and sociodemographic risk factors, the hazard ratio for HIV infection among men with HPV-positive glans/coronal sulcus specimens was 1.8 (95% CI, 1.1-2.9), compared with men with HPV-negative glans/coronal sulcus specimens.

Conclusion: The results suggest an independent increased risk of HIV seroconversion among HPV-positive men. If this finding is confirmed in other studies, HPV prevention could be another tool for HIV prevention.

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Figures

Figure 1
Figure 1
Study flow chart
Figure 2
Figure 2
Estimated cumulative incidence of HIV seroconversion across follow-up visits by baseline HPV positivity
Figure 3
Figure 3
Estimated cumulative incidence of HIV seroconversion across follow-up visits by baseline HPV positivity in glans or shaft with type 16 or 18
See this image and copyright information in PMC

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