HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study

Jalil, Emilia Moreira; Bastos, Francisco I.; Melli, Patrícia Pereira dos Santos; Duarte, Geraldo; Simões, Renata Toscano; Yamamoto, Aparecida Yulie; Morais, Rodrigo; Quintana, Silvana Maria

doi:10.1186/1471-2334-13-564

Cited by 21 publications

(20 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The clearance rates observed in our study was significantly lower than reported in studies (68.3 to 80.7%) among HIV-seronegative women. 4,22–25 However previous studies amongst HIV-seropositive women have reported HPV clearance rates that are comparable 16 , higher 4,8,23,26 and even lower 19 than ours. As reported in earlier studies, we too observed lower clearance rates in women having infection with carcinogenic HPV types especially the alpha-9 species, compared to the clearance rate among carcinogenic HPV types.…”

Section: Discussioncontrasting

confidence: 65%

Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

Mane

Sahasrabuddhe

Nirmalkar

et al. 2017

Journal of Clinical Virology

View full text Add to dashboard Cite

Background Several studies in recent years have documented the genotype-specific prevalence of HPV infection and wide diversity and multiplicity of HPV genotypes among HIV-seropositive women. Yet, information on changes in HPV genotype-specific incidence and clearance rates over time, and their correlation with clinical or immunologic factors among HIV-seropositive women is scarce. Objectives We conducted a prospective study to investigate the incidence and clearance rates of cervical HPV genotypes among HIV-seropositive women in India and expand the evidence base in this area of research. Study design Cervical samples were collected from n=215 HIV-seropositive women in Pune, India who underwent two screening visits separated by a median of 11-months (interquartile range: 8–18 months). HPV genotypes were determined by Roche Linear Array HPV assay. Individual genotype-specific and carcinogenicity-grouping-specific HPV incidence and clearance rates were calculated and the associations between incidence/clearance and age and HIV-related metrics were explored. Results Incidence and clearance rates for ‘any HPV’ and ‘carcinogenic HPV’ genotypes were 11.1 and 18.3, and 6.7 and 33.8, per 100 person-years, respectively. Incidence and clearance rates for HPV genotypes of alpha-9 species (HPV16, HPV31, HPV33, HPV35, HPV52 and HPV58) and alpha-7 species (HPV18, HPV39, HPV45, HPV59 and HPV68) were 5.8 and 2.04, and 32.1 and 53.5, per 100 person-years, respectively. Clearance of any HPV type was associated with increasing age of participants (odds ratio: 1.08, 95%CI: 1.004–1.17), although the association marginally lost its statistical significance when adjusted for CD4 counts and antiretroviral therapy status. Conclusions Genotype-specific clearance rates of HPV were higher than corresponding incidence rates. The suggestion of a positive associations of increasing age with HPV clearance points to the need for etiologic studies on age-related hormonal changes on clearance of cervical HPV infection.

show abstract

Section: Discussioncontrasting

confidence: 65%

Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

Mane

Sahasrabuddhe

Nirmalkar

et al. 2017

Journal of Clinical Virology

View full text Add to dashboard Cite

show abstract

“…The most prevalent HPV genotypes were LR-HPV, including HPV-6 and -11, followed by HR-HPV -18, -16 and -31 (Table 1). Greater elimination of HPV was observed in women infected by LR-HPV compared to HR-HPV, but this difference was not significant (Jalil et al, 2013).…”

Section: Prevalence Of Hpv and Cervical Abnormalities In Hiv+ Brazilimentioning

confidence: 75%

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

Freitas

Suehiro²,

Consolaro³

et al. 2016

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Human papillomavirus is a virus that is distributed worldwide, and persistent infection with high-risk genotypes (HR-HPV) is considered the most important factor for the development of squamous cell cervical carcinoma (SCC). However, by itself, it is not sufficient, and other factors may contribute to the onset and progression of lesions. For example, infection with other sexually transmitted diseases such as human immunodeficiency virus (HIV) may be a factor. Previous studies have shown the relationship between HPV infection and SCC development among HIV-infected women in many regions of the world, with great emphasis on low-and middleincome countries (LMICs). Brazil is considered a LMIC and has great disparities across different regions. The purpose of this review was to highlight the current knowledge about HPV infection and cervical abnormalities in HIV+ women in Brazil because this country is an ideal setting to evaluate HIV impact on SCC development and serves as model of LMICs and low-resource settings.

show abstract

“…Of the 6430 potential publications identified from the PubMed and Embase searches, 55 met our inclusion criteria. Figure summarizes publication selection, Table summarizes the characteristics of the included studies, and Tables ,,, (Appendix ) describe the extracted data and their quality.…”

Section: Resultsmentioning

confidence: 99%

“…Figure summarizes publication selection, Table summarizes the characteristics of the included studies, and Tables ,,, (Appendix ) describe the extracted data and their quality. In review 1 , of the effect of HIV status (exposure) on subsequent HPV acquisition and clearance (outcomes), we extracted data from a total of 41 publications reporting on 27 independent studies . In review 2, of the effect of HPV status (exposure) on subsequent HIV acquisition (outcome), we extracted data from a total of 15 publications reporting results from 11 independent studies .…”

Section: Resultsmentioning

confidence: 99%

Evidence of synergistic relationships between HIV and Human Papillomavirus (HPV): systematic reviews and meta‐analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status

et al. 2018

View full text Add to dashboard Cite

IntroductionObservational studies suggest HIV and human papillomavirus (HPV) infections may have multiple interactions. We reviewed the strength of the evidence for the influence of HIV on HPV acquisition and clearance, and the influence of HPV on HIV acquisition.MethodsWe performed meta‐analytic systematic reviews of longitudinal studies of HPV incidence and clearance rate by HIV status (review 1) and of HIV incidence by HPV status (review 2). We pooled relative risk (RR) estimates across studies using random‐effect models. I 2 statistics and subgroup analyses were used to quantify heterogeneity across estimates and explore the influence of participant and study characteristics including study quality. Publication bias was examined quantitatively with funnel plots and subgroup analysis, as well as qualitatively.Results and DiscussionIn review 1, 37 publications (25 independent studies) were included in the meta‐analysis. HPV incidence (pooled RR = 1.55, 95% CI: 1.29 to 1.88; heterosexual males: pooled RR = 1.95, 95% CI: 1.62, 2.34; females: pooled RR = 1.63, 95% CI: 1.26 to 2.11; men who have sex with men: pooled RR = 1.36, 95% CI: 1.01 to 1.82) and high‐risk HPV incidence (pooled RR = 2.20, 95% CI: 1.90 to 2.54) was approximately doubled among people living with HIV (PLHIV) whereas HPV clearance rate (pooled RR = 0.53, 95% CI: 0.42 to 0.67) was approximately halved. In review 2, 14 publications (11 independent studies) were included in the meta‐analysis. HIV incidence was almost doubled (pooled RR = 1.91, 95% CI 1.38 to 2.65) in the presence of prevalent HPV infection. There was more evidence of publication bias in review 2, and somewhat greater risk of confounding in studies included in review 1. There was some evidence that adjustment for key confounders strengthened the associations for review 2. Misclassification bias by HIV/HPV exposure status could also have biased estimates toward the null.ConclusionsThese results provide evidence for synergistic HIV and HPV interactions of clinical and public health relevance. HPV vaccination may directly benefit PLHIV, and help control both HPV and HIV at the population level in high prevalence settings. Our estimates of association are useful for mathematical modelling. Although observational studies can never perfectly control for residual confounding, the evidence presented here lends further support for the presence of biological interactions between HIV and HPV that have a strong plausibility.

show abstract

HPV clearance in postpartum period of HIV-positive and negative women: a prospective follow-up study

Cited by 21 publications

References 48 publications

Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

Evidence of synergistic relationships between HIV and Human Papillomavirus (HPV): systematic reviews and meta‐analyses of longitudinal studies of HPV acquisition and clearance by HIV status, and of HIV acquisition by HPV status

Contact Info

Product

Resources

About