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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Type-specific cervico-vaginal human papillomavirus infection increases risk of HIV acquisition independent of other sexually transmitted infections
PLoS ONE, Volume 5, No. 4, Article e10094, Year 2010
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Description
Background: Sexually transmitted infections (STIs) such as herpes simplex virus (HSV)-2 are associated with an increased risk of HIV infection. Human papillomavirus (HPV) is a common STI, but little is know about its role in HIV transmission. The objective of this study was to determine whether cervico-vaginal HPV infection increases the risk of HIV acquisition in women independent of other common STIs. Methods and Findings: This prospective cohort study followed 2040 HIV-negative Zimbabwean women (average age 27 years, range 18-49 years) for a median of 21 months. Participants were tested quarterly for 29 HPV types (with L1 PCR primers) and HIV (antibody testing on blood samples with DNA or RNA PCR confirmation). HIV incidence was 2.7 per 100 woman-years. Baseline HPV prevalence was 24.5%, and the most prevalent HPV types were 58 (5.0%), 16 (4.7%), 70 (2.4%), and 18 (2.3%). In separate regression models adjusting for baseline variables (including age, high risk partner, positive test for STIs, positive HSV-2 serology and condom use), HIV acquisition was associated with having baseline prevalent infection with HPV 58 (aHR 2.13; 95% CI 1.09-4.15) or HPV 70 (aHR 2.68; 95% CI 1.08-6.66). In separate regression models adjusting for both baseline variables and time-dependent variables (including HSV-2 status, incident STIs, new sexual partner and condom use), HIV acquisition was associated with concurrent infection with any non-oncogenic HPV type (aHR 1.70; 95% CI 1.02-2.85), any oncogenic HPV type (aHR 1.96; 95% CI 1.16-3.30), HPV 31 (aHR 4.25; 95% CI 1.81-9.97) or HPV 70 (aHR 3.30; 95% CI 1.50-7.20). Detection of any oncogenic HPV type within the previous 6 months was an independent predictor of HIV acquisition, regardless of whether HPV status at the HIV acquisition visit was included (aHR 1.95; 95% CI 1.19-3.21) or excluded (aHR 1.96; 95% CI 1.02-2.85) from the analysis. Conclusions/Significance: Cervico-vaginal HPV infection was associated with an increased risk of HIV acquisition in women, and specific HPV types were implicated in this association. The observational nature of our study precludes establishment of causation between HPV infection and HIV acquisition. However, given the high prevalence of HPV infection in women, further investigation of the role of HPV in HIV transmission is warranted. © 2010 Smith-McCune et al.
Authors & Co-Authors
Smith-McCune, Karen K.
United States, San Francisco
University of California, San Francisco
Shiboski, Stephen C.
United States, San Francisco
University of California, San Francisco
Chirenje, Mike Zvavahera
United States, Oakland
University of Zimbabwe
Magure, Tsitsi Mildred
United States, Oakland
University of Zimbabwe
Tuveson, Jennifer L.
United States, San Francisco
University of California, San Francisco
Ma, Yifei
United States, San Francisco
University of California, San Francisco
da Costa, María M.
United States, San Francisco
University of California, San Francisco
Mościcki, Anna Barbara
United States, San Francisco
University of California, San Francisco
Palefsky, Joel Michael
United States, San Francisco
University of California, San Francisco
Makunike-Mutasa, Rudo
United States, Oakland
University of Zimbabwe
Chipato, Tsungai
United States, Oakland
University of Zimbabwe
van der Straten, Ariane
United States, San Francisco
University of California, San Francisco
United States, Research Triangle Park
Rti International
Sawaya, George F.
United States, San Francisco
University of California, San Francisco
Statistics
Citations: 84
Authors: 13
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pone.0010094
ISSN:
19326203
Research Areas
Cancer
Genetics And Genomics
Infectious Diseases
Sexual And Reproductive Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Participants Gender
Female