Prevalence, Incidence, and Type‐Specific Persistence of Human Papillomavirus in Human Immunodeficiency Virus (HIV)–Positive and HIV‐Negative Women

Ahdieh, Linda; Klein, Robert S.; Burk, Robert D.; Cu‐Uvin, Susan; Schuman, Paula; Duerr, Ann; Safaeian, Mahboobeh; Astemborski, Jacquie; Daniel, Richard; Shah, Keerti V.

doi:10.1086/323081

Cited by 285 publications

(230 citation statements)

References 24 publications

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“…We also found that HIV-1 infection was independently associated with an increase in SIL among HPV-positive women and that HIV-1 represented an important risk factor for the presence of HSIL. These findings are in agreement with other African series (La Ruche et al, 1998;Chirenje et al, 2002;Hawes et al, 2003) and with many studies in industrialised countries (Sun et al, 1997;Ahdieh et al, 2001;Moscicki et al, 2004b;Strickler et al, 2005).…”

Section: Discussionsupporting

confidence: 93%

“…Although HR-HPV infection rates were much higher, there was no statistically significant association with age among the HIV-1-positive women, possibly reflecting the process of upregulation and persistence of HPV elicited by HIV-1, as suggested by others (Palefsky et al, 1999;Ahdieh et al, 2001;Moscicki et al, 2004b), independent of age.…”

Section: Discussionmentioning

confidence: 66%

“…Furthermore, the high background prevalence of human immunodeficiency virus type 1 (HIV-1) observed in many African settings adds complexity to our understanding of the epidemiology of HPV and cervical neoplasia. Studies conducted in industrialised countries have shown that HIV-1 alters the natural history of HPV infection by upregulating HPV persistence and recurrences, thereby facilitating progression to high-grade lesions and cancer (Sun et al, 1997;Ahdieh et al, 2001;Strickler et al, 2005). Consequently, cervical cancer has been included in the list of AIDS-defining opportunistic conditions by the Centres for Disesase Control and Prevention (Centers for Disease Control and Prevention, 1993).…”

mentioning

confidence: 99%

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Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso

et al. 2006

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Human papillomavirus (HPV) infection and cervical squamous intraepithelial lesions (SILs) were studied in 379 high-risk women. Human papillomavirus DNA was detected in 238 of 360 (66.1%) of the beta-globin-positive cervical samples, and 467 HPV isolates belonging to 35 types were identified. Multiple (2 -7 types) HPV infections were observed in 52.9% of HPV-infected women. The most prevalent HPV types were HPV-52 (14.7%), HPV-35 (9.4%), HPV-58 (9.4%), HPV-51 (8.6%), HPV-16 (7.8%), HPV-31 (7.5%), HPV-53 (6.7%), and HPV-18 (6.4%). Human immunodeficiency virus type 1 (HIV-1) seroprevalence was 36.0%. Human papillomavirus prevalence was significantly higher in HIV-1-infected women (87 vs 54%, prevalence ratio ( Cervical cancer is the most frequent cancer of women in developing countries, particularly in sub-Saharan Africa (Parkin et al, 1999), and it is now well established that genital infection with certain types of human papillomavirus (HPV) causes virtually all cases of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (ICC) (Walboomers et al, 1999). The HPV types that infect the genital tract have been subdivided into low-risk (LR) types, which are principally found in nonmalignant lesions such as genital warts, and high-risk (HR) types, which are associated with the development of CIN and ICC. Human papillomavirus types 6, 11, 40, 42, 43, 44, 54, 61, 70, 72, 81, and 89 are classified as LR types, whereas types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82 are classified as HR types. In addition, HPV types 26, 53, and 66 are considered as probably carcinogenic (Muñoz et al, 2003).Human papillomavirus prophylactic vaccines are now being developed and promising results have been obtained with recombinant L1 capsid protein virus-like particles (VLPs). However, the current HPV vaccines target the most prevalent high-risk HPV (HR-HPV) types worldwide, namely HPV-16 and HPV-18 (Koutsky et al, 2002;Ault et al, 2004;Brown et al, 2004;Harper et al, 2004). It has been shown that crossneutralisation induced by L1 VLPs represents less than 1% of the neutralising activity induced by the dominant conformational epitope , indicating that current HPV vaccines would be able to confer only type-specific immunity. Therefore, effectiveness of these vaccines on the prevention of cancer may be lower in populations highly affected by HR-HPV types other than HPV-16 and HPV-18. Thus, it is important to document the distribution of HPV genotypes in HPV-infected women and in women with cervical neoplasia in African countries in order to assess the potential effectiveness of a bivalent HPV-16/18 vaccine.There have been few detailed studies of HPV genotypes and their association with intraepithelial lesions or ICC in sub-Saharan Africa. Available data suggest, however, a higher prevalence and wider spectrum of oncogenic HPV types compared to studies conducted elsewhere (Castellsague et al, 2001;De Vuyst et al, 2003;Mayaud et al, 2003;Clifford et al, 2005;Wall et al, 2005). Furthermore, the high backgr...

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 66%

mentioning

confidence: 99%

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Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso

et al. 2006

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“…In a further study, the presence of multiple infections was strongly associated with HPV persistence in HIV-infected women. 43 Thus, carriers of multiple HPV types might have deficient immune responses to HPV that predispose them to persistent infection. In the present study none of the patients were HIV-positive.…”

Section: Discussionmentioning

confidence: 99%

Impact of multiple HPV infection on response to treatment and survival in patients receiving radical radiotherapy for cervical cancer

Bachtiary

Obermair

Dreier

et al. 2002

Intl Journal of Cancer

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To obtain information on the incidence and the clinical significance of infection with various types of the human papillomavirus (HPV) in cancer of the uterine cervix, we retrospectively examined the HPV status of 106 patients who had received radical radiotherapy for cervical cancer stages IB to IIIB. DNA was extracted from formalin-fixed, paraffinembedded biopsies and PCR was carried out to identify HPV types 16, 18, 31, 35, 33 and 45. To detect additional HPV types, consensus PCR products were cloned and sequenced. A catalyzed signal-amplified colorimetric in situ hybridization was carried out in 84 of 106 specimens as a positive control. Response to therapy, progression-free survival (PFS) and cervical cancer-specific survival (CCSS) were the statistical endpoints. Survival analysis was carried out using univariate and multivariate analysis (Cox regression). Ninety-six patients (90.6%) were HPV-positive and 42/96 (43.7%) were positive for multiple HPV types. Eight patients had persistent disease after radiotherapy. From these 8 patients, 7 were infected with multiple HPV types and only 1 patient had an infection with a single HPV type. After a median follow up period of 50 months, patients with multiple HPV infection had a significantly shorter PFS and CCSS compared to those with single HPV infection (24.8% and 34.9% vs. 64% and 60.8%, Log rank, p < 0.01 and 0.04). In multivariate analysis, the presence of multiple HPV types (RR 1.9), node status (RR 2.3), tumor size (RR 3.2) and histologic type (RR 4.8) were independent prognostic factors of CCSS. Our results demonstrate that the presence of multiple HPV types is associated with poor response and with reduced survival in cervical cancer patients who receive radiotherapy as the primary treatment.

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“…Several longitudinal studies of HPV infection have demonstrated that HIV-infected women are more likely than HIV-negative women to have cervical HPV of all types: low risk types (6,11,26,40,53,54,55,66,83,84), medium risk types (33,35,39,51,52,56,58,59,68,73,82), and high risk types (16,18,31,45), more likely to have persistence of cervical HPV over time, and more likely to have a high viral signal of their HPV. Moreover HPV persistence is associated with CD4 counts <200 cells/µl, and the presence of HPV is associated with an increase in progression and decrease in regression (55,65,79,80). HPV is thought to be more associated with SILs than HIV infection alone.…”

Section: Lower Genital Tract Neoplasiasmentioning

confidence: 99%

Gynecologic issues in the HIV-infected woman

Cejtin

2003

Obstetrics and Gynecology Clinics of North America

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Prevalence, Incidence, and Type‐Specific Persistence of Human Papillomavirus in Human Immunodeficiency Virus (HIV)–Positive and HIV‐Negative Women

Cited by 285 publications

References 24 publications

Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso

Human papillomavirus genotype distribution and cervical squamous intraepithelial lesions among high-risk women with and without HIV-1 infection in Burkina Faso

Impact of multiple HPV infection on response to treatment and survival in patients receiving radical radiotherapy for cervical cancer

Gynecologic issues in the HIV-infected woman

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