Type-Specific Cervico-Vaginal Human Papillomavirus Infection Increases Risk of HIV Acquisition Independent of Other Sexually Transmitted InfectionsReportar como inadecuado




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Background

Sexually transmitted infections STIs such as herpes simplex virus HSV-2 are associated with an increased risk of HIV infection. Human papillomavirus HPV is a common STI, but little is know about its role in HIV transmission. The objective of this study was to determine whether cervico-vaginal HPV infection increases the risk of HIV acquisition in women independent of other common STIs.

Methods and Findings

This prospective cohort study followed 2040 HIV-negative Zimbabwean women average age 27 years, range 18–49 years for a median of 21 months. Participants were tested quarterly for 29 HPV types with L1 PCR primers and HIV antibody testing on blood samples with DNA or RNA PCR confirmation. HIV incidence was 2.7 per 100 woman-years. Baseline HPV prevalence was 24.5%, and the most prevalent HPV types were 58 5.0%, 16 4.7%, 70 2.4%, and 18 2.3%. In separate regression models adjusting for baseline variables including age, high risk partner, positive test for STIs, positive HSV-2 serology and condom use, HIV acquisition was associated with having baseline prevalent infection with HPV 58 aHR 2.13; 95% CI 1.09–4.15 or HPV 70 aHR 2.68; 95% CI 1.08–6.66. In separate regression models adjusting for both baseline variables and time-dependent variables including HSV-2 status, incident STIs, new sexual partner and condom use, HIV acquisition was associated with concurrent infection with any non-oncogenic HPV type aHR 1.70; 95% CI 1.02–2.85, any oncogenic HPV type aHR 1.96; 95% CI 1.16–3.30, HPV 31 aHR 4.25; 95% CI 1.81–9.97 or HPV 70 aHR 3.30; 95% CI 1.50–7.20. Detection of any oncogenic HPV type within the previous 6 months was an independent predictor of HIV acquisition, regardless of whether HPV status at the HIV acquisition visit was included aHR 1.95; 95% CI 1.19–3.21 or excluded aHR 1.96; 95% CI 1.02–2.85 from the analysis.

Conclusions-Significance

Cervico-vaginal HPV infection was associated with an increased risk of HIV acquisition in women, and specific HPV types were implicated in this association. The observational nature of our study precludes establishment of causation between HPV infection and HIV acquisition. However, given the high prevalence of HPV infection in women, further investigation of the role of HPV in HIV transmission is warranted.



Autor: Karen K. Smith-McCune , Stephen Shiboski, Mike Z. Chirenje, Tsitsi Magure, Jennifer Tuveson, Yifei Ma, Maria Da Costa, Anna-Barba

Fuente: http://plos.srce.hr/



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