Increased Risk of HIV Acquisition among Kenyan Men with Human Papillomavirus Infection

Abstract

Background Few data are available concerning the effect of human papillomavirus (HPV) infection on HIV acquisition. Methods HIV-seronegative, sexually active 18-24 year-old Kenyan men within a randomized trial of male circumcision provided penile exfoliated cells from two anatomical sites (glans/coronal sulcus, and shaft) at baseline. The GP5+/6+ PCR assay ascertained a wide range of HPV DNA types at the baseline visit. Risk of HIV infection [95% confidence interval (CI)] was estimated using Kaplan-Meier methods, and hazard ratios (HR)[95% CI] from proportional hazards models. Results Among 2,168 uncircumcised men with baseline HPV data, 1,089 (50%) were HPV DNA positive. Cumulative incidence of HIV infection by 42-months was 5.8% [95% CI 3.6, 7.9] in men with HPV-positive glans specimens versus 3.7% [1.8, 5.6] in men with HPV-negative glans specimens (p=0.01). Controlling for subsequent circumcision status, baseline HSV-2 serostatus, and sexual and sociodemographic risk factors, the HR of HIV infection in men with HPV-positive glans specimens was 1.8 [1.1, 2.9] compared to men with HPV-negative glans specimens. Conclusion Results suggest an independent, increased risk of HIV seroconversion among HPV positive men. If confirmed in other studies, HPV prevention could be another tool for HIV prevention.

Lopinavir Up-Regulates Expression of the Antiviral Protein Ribonuclease L in Human Papillomavirus-Positive Cervical Carcinoma Cells

“…This is highly significant when considered with the previously discussed findings that genital HPV infections can predispose to increased risk of HIV transmission in both men and women [29,30].…”

“…With current pricing strategies, anti-HPV vaccines are not an option in such settings, and as previously discussed, they will most likely have reduced efficacy in HIV-positive women. Furthermore, in view of the observation that infection with HPV can enhance the sexual transmission of HIV in both men and women [29,30], this clearly indicates that a simple, non-surgical treatment for HPV-related precancerous lesions may not only reduce the burden of cervical cancer but may also reduce the chances of HIV transmission.…”

Human papillomavirus infection and disease in men: Impact of HIV

“…[9] Although data on anogenital HPV DNA prevalence in men in SSA are also limited, [3] overall reported prevalences in men are high, ranging from 19% to 78%. [10][11][12][13][14][15] In most, but not all studies, the most prevalent type was HPV-16. [15] The observed heterogeneity in estimates can be attributed to differences in age distribution, sexual behaviour and HIV prevalence within the different populations.…”

“…Lack of circumcision and HIV infection have been identified as risk factors for AGWs in men. [12] Importantly, HIVpositive men with AGWs may also be at risk for infection with HR-HPV. In a small study in Johannesburg among HIV-positive men with penile warts, 85% were found to have HR-HPV as well.…”

Type-Specific Detection of 30 Oncogenic Human Papillomaviruses by Genotyping both E6 and L1 Genes

“…An HPV subset is also clearly implicated in the development of human anal, vaginal, vulvar, penile, and oropharyngeal malignancies (2,(9)(10)(11). Moreover, anal HPV infections, especially highrisk types, were suggested previously to be independently associated with HIV acquisition (12).…”