This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (43)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pediatrics, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Impact of Infection With Human Immunodeficiency Virus

Anna-Barbara Moscicki, MD; Jonas H. Ellenberg, PhD; Sten H. Vermund, MD, MPH; Christie A. Holland, PhD; Teresa Darragh, MD; Peggy A. Crowley-Nowick, PhD; Linda Levin, MD; Craig M. Wilson, MD

Arch Pediatr Adolesc Med. 2000;154:127-134.

Context  Data suggest that in adults, human papillomavirus (HPV) infections and their sequalae, squamous intraepithelial lesions (SILs), occur more commonly among human immunodeficiency (HIV)–infected women because of the HIV-associated CD4⁺ T-cell immunosuppression. Since adolescents are more likely to be early in the course of HIV and HPV infections, the study of both infections in this age group may help elucidate their initial relationship.

Objective  To examine the prevalence of and risks for cervical HPV infection and SILs by HIV status in a population of adolescent girls.

Participants  Subjects recruited at each of the 16 different US sites participating in a national study of HIV infection in adolescents.

Main Outcome Measures  Cervical HPV DNA findings using polymerase chain reaction detection techniques and Papanicolaou smear from baseline visits. Infection with HPV was categorized into low- (rarely associated with cancer) and high- (commonly associated with cancers) risk types.

Results  Of 133 HIV-infected girls, 103 (77.4%) compared with 30 (54.5%) of 55 noninfected girls were positive for HPV (relative risk [RR], 1.4; 95% confidence interval [CI], 1.1-1.8). The risk was for high-risk (RR, 1.8; 95% CI, 1.2-2.7) but not low-risk (RR, 1.2; 95% CI, 0.4-3.9) HPV types. Among the girls with HPV infection, 21 (70.0%) of the non–HIV-infected girls had normal cytologic findings compared with only 29 (29.9%) of the HIV-infected girls (P<.001). Multivariate analysis showed that HIV status was a significant risk for HPV infection (odds ratio [OR], 3.3; 95% CI, 1.6-6.7) and SIL (OR, 4.7; 95% CI, 1.8-14.8), but CD4 cell count and viral load were not associated with infection or squamous intraepithelial lesions. Only 9 girls had a CD4⁺ T-cell count of less than 0.2 cell x 10⁹/L.

Conclusions  High prevalence of HPV infection in both groups underscores the risky sexual behavior in this adolescent cohort. Rates of HPV infection and SILs were higher among HIV-infected girls, despite similar sexual risk behaviors and the relatively healthy state of our HIV-infected group. Infection with HIV may enhance HPV proliferation through mechanisms other than CD4 immunosuppression, particularly early in the course of HIV infection.

From the Departments of Pediatrics (Dr Moscicki) and Anatomic Pathology (Dr Darragh), University of California, San Francisco; Biostatistics, Westat Inc, Rockville, Md (Dr Ellenberg); the Departments of Medicine (Dr Vermund) and Pediatrics (Dr Wilson), Center for Virology, Immunology, and Infectious Diseases, University of Alabama at Birmingham; Children's Medical Center, Washington, DC (Dr Holland); The Fearing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (Dr Crowley-Nowick); and Department of Pediatrics, Mt Sinai Medical Center, New York, NY (Dr Levin).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cervical and Vulvar Cancer Risk in Relation to the Joint Effects of Cigarette Smoking and Genetic Variation in Interleukin 2
Hussain et al.
Cancer Epidemiol. Biomarkers Prev. 2008;17:1790-1799.
ABSTRACT | FULL TEXT  

Interleukin-10 Gene (IL10) Polymorphisms and Human Papillomavirus Clearance among Immunosuppressed Adolescents
Shrestha et al.
Cancer Epidemiol. Biomarkers Prev. 2007;16:1626-1632.
ABSTRACT | FULL TEXT  

Reproductive Health of Adolescent Girls Perinatally Infected With HIV
Brogly et al.
AJPH 2007;97:1047-1052.
ABSTRACT | FULL TEXT  

High Level of Correlation of Human Papillomavirus-16 DNA Viral Load Estimates Generated by Three Real-time PCR Assays Applied on Genital Specimens
Fontaine et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:2200-2207.
ABSTRACT | FULL TEXT  

Natural History and Possible Reactivation of Human Papillomavirus in Human Immunodeficiency Virus-Positive Women
Strickler et al.
JNCI J Natl Cancer Inst 2005;97:577-586.
ABSTRACT | FULL TEXT  

Human Papillomavirus Type 16 Viral Load Is Higher in Human Immunodeficiency Virus-Seropositive Women with High-Grade Squamous Intraepithelial Lesions Than in Those with Normal Cytology Smears
Lefevre et al.
J. Clin. Microbiol. 2004;42:2212-2215.
ABSTRACT | FULL TEXT  

Genital Dysplasia in Women Infected with Human Immunodeficiency Virus
Taylor et al.
J Am Board Fam Med 2004;17:108-113.
ABSTRACT | FULL TEXT  

Chapter 6: Immunosuppression and Co-infection with HIV
Palefsky and Holly
J Natl Cancer Inst Monogr 2003;2003:41-46.
ABSTRACT | FULL TEXT  

Role of Immune Function in Human Papillomavirus Infection
Buchanan et al.
JAMA 2001;286:1173-1174.
FULL TEXT  

Cell-Mediated Immune Response to Human Papillomavirus Infection
Scott et al.
CVI 2001;8:209-220.
FULL TEXT