Risk Factors for Human Papillomavirus Infection and Abnormal Cervical Cytology Among Perinatally Human Immunodeficiency Virus-Infected and Uninfected Asian Youth
Author:
Sohn Annette H1, Kerr Stephen J23, Hansudewechakul Rawiwan4, Gatechompol Sivaporn2, Chokephaibulkit Kulkanya5, Dang Hanh Le Dung6, Tran Dan Ngoc Hanh7, Achalapong Jullapong4, Teeratakulpisarn Nipat2, Chalermchockcharoenkit Amphan5, Thamkhantho Manopchai5, Pankam Tippawan8, Singtoroj Thida1, Termrungruanglert Wichai9, Chaithongwongwatthana Surasith9, Phanuphak Nittaya8, , Gatechompol Sivaporn, Kerr Stephen, Ruengpanyathip Chavalun, Chokephaibulkit Kulkanya, Thamkhantho Manopchai, Chalermchockcharoenkit Amphan, Sricharoenchai Sirintip, Hansudewechakul Rawiwan, Achalapong Jullapong, Wanchaitanawong Vanichaya, Hanh Dang Le Dunh, Dung Dang Ngoc Yen, Thang Tran Dang, Tran Dan Ngoc Hanh, Truong Khanh Huu, Chaithongwongwatthana Surasith, Termrungruanglert Wichai, Triratanachat Surang, Sirivichayakul Sunee, Palefsky Joel M, Phanuphak Nittaya, Teeratakulpisarn Nipat, Pankam Tippawan, Sohn Annette, Ross Jeremy, Singtoroj Thida, Pongchaisit Waropart, Kosaphan Kamonrat
Affiliation:
1. TREAT Asia/amfAR–Foundation for AIDS Research 2. HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand 3. Kirby Institute, University of New South Wales, Sydney, Australia 4. Chiangrai Prachanukroh Hospital, Chiang Rai 5. Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 6. Hung Vuong Hospital 7. Children’s Hospital 1, Ho Chi Minh City, Vietnam 8. Thai Red Cross AIDS Research Centre, Bangkok, Thailand 9. Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
Abstract
AbstractBackgroundInfection with high-risk human papillomavirus (HR-HPV) may be higher in perinatally human immunodeficiency virus (HIV)–infected (PHIV) than HIV-uninfected (HU) adolescents because of long-standing immune deficiency.MethodsPHIV and HU females aged 12–24 years in Thailand and Vietnam were matched by age group and lifetime sexual partners. At enrollment, blood, cervical, vaginal, anal, and oral samples were obtained for HPV-related testing. The Wilcoxon and Fisher exact tests were used for univariate and logistic regression for multivariate analyses.ResultsNinety-three PHIV and 99 HU adolescents (median age 19 [18–20] years) were enrolled (June 2013–July 2015). Among PHIV, 94% were currently receiving antiretroviral therapy, median CD4 count was 593 (392–808) cells/mm3, and 62% had a viral load <40 copies/mL. Across anogenital compartments, PHIV had higher rates of any HPV detected (80% vs 60%; P = .003) and any HR-HPV (60% vs 43%, P = .02). Higher proportions of PHIV had abnormal Pap smears (eg, atypical squamous cells of unknown significance [ASC-US], 12% vs 14%; low-grade squamous intraepithelial neoplastic lesions, 19% vs 1%). After adjusting for ever being pregnant and asymptomatic sexually transmitted infections (STI) at enrollment, PHIV were more likely to have HR-HPV than HU (odds ratio, 2.02; 95% confidence interval, 1.09–3.77; P = .03).ConclusionsPerinatal HIV infection was associated with a higher risk of HR-HPV and abnormal cervical cytology. Our results underscore the need for HPV vaccination for PHIV adolescents and for prevention and screening programs for HPV and other STIs.
Funder
NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development LIFE+, Austria TREAT Asia amfAR, the Foundation for AIDS Research SEARCH/Thai Red Cross AIDS Research Centre ViiV Healthcare
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
Cited by
19 articles.
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