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. 2011 Apr 15;203(8):1182-91.
doi: 10.1093/infdis/jiq172.

Increases in human papillomavirus detection during early HIV infection among women in Zimbabwe

Rebecca G Nowak  1 , Patti E Gravitt, Charles S Morrison, Stephen J Gange, Cynthia Kwok, Amy E Oliver, Roslyn Howard, Barbara Van der Pol, Robert A Salata, Nancy S Padian, Tsungai Chipato, Marshall Munjoma, David D Celentano
Affiliations

Increases in human papillomavirus detection during early HIV infection among women in Zimbabwe

Rebecca G Nowak et al. J Infect Dis. .

Abstract

Background: Individuals who acquire human immunodeficiency virus (HIV) may experience an immediate disruption of genital tract immunity, altering the ability to mount a local and effective immune response. This study examined the impact of early HIV infection on new detection of human papillomavirus (HPV).

Methods: One hundred fifty-five Zimbabwean women with observation periods before and after HIV acquisition and 486 HIV-uninfected women were selected from a cohort study evaluating hormonal contraceptive use and risk of HIV acquisition. Study visits occurred at 3-month intervals. Cervical swab samples available from up to 6 months before, at, and up to 6 months after the visit when HIV was first detected were typed for 37 HPV genotypes or subtypes.

Results: We observed ∼5-fold higher odds of multiple (≥2) new HPV detections only after HIV acquisition, relative to HIV-negative women after adjusting for sexual behavior and concurrent genital tract infections. We also observed ∼2.5-fold higher odds of single new HPV detections at visits before and after HIV acquisition, relative to HIV-uninfected women in multivariable models.

Conclusions: These findings suggest that HIV infection has an immediate impact on genital tract immunity, as evidenced by the high risk of multiple new HPV detections immediately after HIV acquisition.

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Figures

Figure 1.
Figure 1.
Newly detected human papillomavirus (HPV) infection by follow-up time for human immunodeficiency virus (HIV)–uninfected and HIV-infected participants. The last visit before that when HIV was detected (pre-index visit; t−1) serves as the reference category; estimates were adjusted for lifetime number of sex partners, primar partner risk, and genital tract infections (composite sexually transmitted infection). Adjusted for lifetime number sex partners, primary partner risk and composite STI. CI, confidence interval; HPV, human papillomavirus; OR, odds ratio; ref, reference group; tindex, index visit; t+1, first visit after that when HIV was detected; t+2, second visit after that when HIV was detected.
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