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- Title
Human Papillomavirus Type 16 and Immune Status in Human Immunodeficiency Virus-Seropositive Women.
- Authors
Strickler, Howard D.; Palefsky, Joel M.; Chetrit, Angela; Lubin, Flora; Menczer, Joseph; Ebbers, Sarah; Tucker, Margaret A.; Struewing, Jeffery P.; Hartge, Patricia
- Abstract
Background: Human papillomavirus (HPV) type 16 is etiologically associated with approximately half of all cervical cancers. It is important, therefore, to determine the characteristics that distinguish HPV16 from other HPV types. A preliminary result based on cross-sectional baseline data in the Women's Interagency Human Immunodeficiency Virus (HIV) Study (WIHS) suggested that the prevalence of HPV16 might have a weaker association with immune status in HIV-seropositive women than that of other HPV types. To address this issue, we examined HPV test results from repeated study visits in the WIHS and from an independent study, the HIV Epidemiology Research Study (HERS). Methods: HIV-seropositive women in the WIHS (n = 2058) and in the HERS (n = 871) were assessed semiannually. HPV DNA was detected in cervicovaginal lavage specimens by using polymerase chain reaction assays. Prevalence ratios were used to compare the prevalence of each HPV type in women with the lowest CD4+ T-cell counts (<200 T cells/ mm³) with that of women with the highest CD4+ T-cell counts (≥500 T cells/mm³). A summary prevalence ratio for each HPV type (i.e., across visits and studies) was estimated using generalized estimating equations. The association of CD4+ T-cell stratum with type-specific HPV incidence was measured using multivariable Cox regression models. All statistical tests were two-sided. Results: The prevalence ratio for HPV16 was low compared with that of other HPV types at every study visit in both cohorts. The generalized estimating equation summary prevalence ratio for HPV16 (1.25, 95 % confidence interval [CI] = 0.97 to 1.62) was the smallest measured, and it was statistically significantly lower than that of all other HPV types combined (P = .01). The association of CD4+ T-cell stratum with HPV16 incidence was also among the smallest measured (hazard ratio = 1.69, 95 % CI = 1.01 to 2.81). Conclusions: The prevalent and incident detection of HPV16 is more...
- Subjects
PAPILLOMAVIRUSES; CERVICAL cancer
- Publication
JNCI: Journal of the National Cancer Institute, 2003, Vol 95, Issue 14, p1062
- ISSN
0027-8874
- Publication type
Article
- DOI
10.1093/jnci/95.14.1062