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Evaluation of HIV and Highly Active Antiretroviral Therapy on the Natural History of Human Papillomavirus Infection and Cervical Cytopathologic Findings in HIV-Positive and High-Risk HIV-Negative Women
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Evaluation of HIV and Highly Active Antiretroviral Therapy on the Natural History of Human Papillomavirus Infection and Cervical Cytopathologic Findings in HIV-Positive and High-Risk HIV-Negative Women
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Evaluation of HIV and Highly Active Antiretroviral Therapy on the Natural History of Human Papillomavirus Infection and Cervical Cytopathologic Findings in HIV-Positive and High-Risk HIV-Negative Women
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Journal Article
Evaluation of HIV and Highly Active Antiretroviral Therapy on the Natural History of Human Papillomavirus Infection and Cervical Cytopathologic Findings in HIV-Positive and High-Risk HIV-Negative Women
2013
Overview
Background. The Canadian Women's HIV Study (CWHS) enrolled human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women in a longitudinal cohort. This analysis considered the effects of HIV and highly active antiretroviral therapy (HAART) on HPV persistence and cervical squamous intraepithelial lesions (SILs). Methods. Longitudinal cytopathologic and HPV DNA results were analyzed using multistate models. States of cervical SIL were defined as absent, present, and treatment; HPV states were defined as negative or positive. Demographic variables and markers of sexual activity were considered predictors. Results were calculated on the basis of transition probabilities and reported as hazard ratios (HRs). Results. The CWHS followed 750 HIV-positive and 323 HIV-negative women during 1993-2002. A total of 467 and 456 women were included in the longitudinal cervical cytopathologic and HPV DNA analyses, respectively. HIV-positive women had increased prevalence (46.6% vs 28.7%; P<.0001), increased acquisition (HR, 2.3; P= .03), and decreased clearance (HR, 0.4; P <.001) of oncogenic HPV as compared to HIV-negative women. Oncogenic HPV infection predicted progression of cervical dysplasia from normal to abnormal SIL (HR, 2.8; P = .002). Among HIVpositive participants, HAART increased the likelihood of regression (from present to absent) of cervical SIL (HR, 3.3; P = .02) and increased the clearance of oncogenic HPV types other than HPV-16 or HPV-18 (HR, 2.2; P = .01). Conclusions. This analysis demonstrated beneficial effects of HAART on cervical SIL in HIV-positive women.
Publisher
Oxford University Press
Subject
/ AIDS
/ Antiretroviral Therapy, Highly Active - methods
/ Biological and medical sciences
/ Cervical Intraepithelial Neoplasia - epidemiology
/ Cervical Intraepithelial Neoplasia - pathology
/ Cytology
/ Female
/ Fundamental and applied biological sciences. Psychology
/ Highly active antiretroviral therapy
/ HIV
/ HIV Infections - complications
/ HIV Infections - drug therapy
/ HIV/AIDS
/ Human immunodeficiency virus
/ Humans
/ Lesions
/ Papillomavirus Infections - epidemiology
/ Papillomavirus Infections - pathology
/ Uterine Cervical Neoplasms - epidemiology
/ Uterine Cervical Neoplasms - pathology
/ Viral diseases of the lymphoid tissue and the blood. Aids
/ Virology
