Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 Nov 13;26(17):2211-22.
doi: 10.1097/QAD.0b013e328358d908.

Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis

Catherine F Houlihan  1 , Natasha L Larke, Deborah Watson-Jones, Karen K Smith-McCune, Stephen Shiboski, Patti E Gravitt, Jennifer S Smith, Louise Kuhn, Chunhui Wang, Richard Hayes
Affiliations
Meta-Analysis

Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis

Catherine F Houlihan et al. AIDS. .

Abstract

Objectives: Human papillomavirus (HPV), one of the commonest sexually transmitted infections, may be a cofactor in HIV acquisition. We systematically reviewed the evidence for an association of HPV infection with HIV acquisition in women, heterosexual men and men who have sex with men (MSM).

Design: : Systematic review and meta-analysis.

Methods: Studies meeting inclusion criteria in Pubmed, Embase and conference abstracts up to 29 July 2011 were identified. Random effects meta-analyses were performed to calculate summary hazard ratios (HR). Publication bias and statistical heterogeneity were evaluated and population attributable fractions (PAFs) calculated.

Results: Eight articles were included, with previously unpublished data from five authors. Seven studies found an association between prevalent HPV and HIV acquisition. Risk of HIV acquisition in women doubled with prevalent HPV infection with any genotype [HR = 2.06 (95% CI = 1.44-2.94), I = 0%], although adjustment for confounders was often inadequate. The effect was similar for high-risk [HR = 1.99 (95% CI = 1.54-2.56), I = 8.4%] and low-risk [HR = 2.01 (95% CI = 1.27-3.20), I = 0%] HPV genotypes with weak evidence of publication bias (P = 0.06). Two studies in men were identified: both showed an association between HPV infection and HIV acquisition. Unpublished data from one of two studies in women indicated an association between genotypes targeted by HPV vaccines and HIV acquisition. PAFs for HIV attributable to infection with any HPV genotype ranged between 21 and 37%.

Conclusion: If further studies validate the association between HPV infection and HIV acquisition, HPV vaccines may reduce HIV incidence in high HPV prevalence populations, in addition to preventing cervical cancer. HIV surveillance studies during implementation of HPV vaccine programmes are warranted.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Results from the systematic search
1After removal of duplicates
Figure 2
Figure 2. Meta-analysis of HIV risk in women associated with (i) Any HPV (ii) High-risk HPV (iii) Low-risk HPV (iv) Persistent HPV and (v) Non-persistent HPV
See this image and copyright information in PMC

Comment in

References

    1. UNAIDS . Global Report: UNAIDS Report on the Global AIDS Epidemic. 2010.
    1. Rerks-Ngarm S, et al. Vaccination with ALVAC and AIDSVAX to prevent HIV-1 infection in Thailand. N Engl J Med. 2009;361(23):2209–20. - PubMed
    1. Freeman EE, et al. Herpes simplex virus 2 infection increases HIV acquisition in men and women: systematic review and meta-analysis of longitudinal studies. AIDS. 2006;20(1):73–83. - PubMed
    1. Winer RL, et al. Risk of female human papillomavirus acquisition associated with first male sex partner. J Infect Dis. 2008;197(2):279–82. - PMC - PubMed
    1. Munoz N, et al. Chapter 1: HPV in the etiology of human cancer. Vaccine. 2006;24(Suppl 3):1–10. - PubMed

Publication types

MeSH terms