Natural History and Possible Reactivation of Human Papillomavirus in Human Immunodeficiency Virus–Positive Women

作者: Howard D. Strickler , Robert D. Burk , Melissa Fazzari , Kathryn Anastos , Howard Minkoff

DOI: 10.1093/JNCI/DJI073

关键词: Viral diseaseSidaHazard ratioAcquired immunodeficiency syndrome (AIDS)PapillomaviridaeBiologyVirusImmunologyVirologyCervical cancerLentivirus

摘要: Background: Little is known in human immunodeficiency virus (HIV)-positive women about how the combination of plasma HIV RNA level and CD4 + T-cell count associated with natural history papillomavirus (HPV) infection or HPV reactivation-whether it occurs what frequency HIV-positive women. Methods: (n = 1848) -negative 514) were assessed at semiannual visits (total person-years 5661) for cervicovaginal polymerase chain reaction assays squamous intraepithelial lesions (SILs) by Pap smear. We studied prevalent detection SILs generalized estimating equations incident persistence multivariable Cox models. All statistical tests two-sided. Results: observed a strong interaction between associations strata both (P .002) .001) HPV. Indeed, hazard ratio peaked 4.0 5.0, either less than 200 cells per mm 3 an more 100000 copies mL. Although all was number recent sex partners trend <.001), 22% sexually inactive cells/mm also had least one incidently detected type. The association /HIV statistically significantly smaller (P<.001) detection. SIL prevalence, detection, similar as (above). Conclusion: In women, appear to have interactive HPV, some which may reflect reactivation (e.g., women). moderate coinfection could partly explain why cervical cancer rates not reached epidemic proportions

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