The impact of the human immunodeficiency virus on the human papillomavirus epidemic

Chopra, K. F.

doi:10.1001/archderm.133.5.629

Cited by 16 publications

(14 citation statements)

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“…Multiple epidemiological studies have reported that HPV infection is detected more frequently, and that the incidence and severity of genital neoplasia are higher among immuno-compromised women, including those with HIV infection. [5][6][7][8][9][10] These data imply that the host immune response to HPV is critical in determining the outcome of HPV infection, and in 1992, invasive cervical cancer was included as an AIDS-defining illness in HIV-positive women by the Centers for Disease Control and Prevention. 11 The exact relationship between altered immune function and the development of HPV-related cervical cancers has not been elucidated.…”

Section: (Am J Pathol 2002 160:151-164)mentioning

confidence: 99%

Lymphoid Follicles Are Generated in High-Grade Cervical Dysplasia and Have Differing Characteristics Depending on HIV Status

Kobayashi¹,

Darragh²,

Herndier³

et al. 2002

The American Journal of Pathology

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The exact role of the mucosal immune response in the pathogenesis of human papillomavirus (HPV)-related premalignant and malignant diseases of the genital tract is poorly understood. We used immunohistochemical analysis to characterize immune cells in normal cervix (N = 21), HIV-negative high-grade dysplasia (N = 21), and HIV-positive high-grade dysplasia (N = 30). Classical germinal centers were present in 4.7% of normal cervix, 33% of high-grade lesions from HIV-negative women, and 3.3% of high-grade lesions from HIV-positive women (P = 0.003). HPV16 E7 antigen was detected in a subset of germinal centers, indicating that the secondary immune response was directed in part against HPV. Lymphoid follicles were present in 9.5% of normal cervix, 57% of HIV-negative high-grade dysplasia, and 50% of HIV-positive high-grade dysplasia (P = 0.001 normal versus high-grade). A novel type of lymphoid aggregate, consisting predominantly of CD8(+) T cells, was detected in 4.8% of normal cervix, 0% of HIV-negative high-grade dysplasia, and 40% of HIV-positive high-grade dysplasia (P < 0.001). The recurrence rate of high-grade dysplasia within one year was significantly higher in women with such CD8(+) T cell-dominant aggregates (P = 0.02). In summary, the types of lymphoid follicle in lesions from HIV-positive women were significantly different from those from HIV-negative women, and these differences are associated with the worse clinical outcome in HIV-positive women.

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Section: (Am J Pathol 2002 160:151-164)mentioning

confidence: 99%

Lymphoid Follicles Are Generated in High-Grade Cervical Dysplasia and Have Differing Characteristics Depending on HIV Status

Kobayashi¹,

Darragh²,

Herndier³

et al. 2002

The American Journal of Pathology

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“…Numerous studies have shown that women who are HIV seropositive (HIV+) have a significantly higher prevalence of cervical dysplasia (2–10) . The causal link between HIV infection and cervical cancer is still not completely understood, but it has been shown that there is a significantly higher prevalence of human papillomavirus virus (HPV) infections in HIV+ women with cervical dysplasia and may be related to the degree of immunosuppression (11,12) . HIV infection may create an environment in which oncogenic subtypes of HPV can persist and lead to malignant transformation of the squamous epithelium of the ano‐genital region (2,3,5,7,10,13–15) .…”

mentioning

confidence: 99%

The false negative rate of cervical smears in high risk HIV seropositive and seronegative women

Goodman¹,

Chaudhuri²,

Tobin-Enos³

et al. 2000

Int J Gynecol Cancer

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We undertook a prospective study of cytology and concurrent colposcopically directed biopsies of both Human Immunodeficiencey Virus seronegative (HIV-) and seropositive (HIV +) women at high risk for cervical intraepithelial neoplasia (CIN) to determine the accuracy of Pap smears in this population. Women were recruited from a sexually transmitted disease clinic and a women's prison in eastern Massachusetts. All were interviewed, blood was tested for HIV with CD4 counts done in 101 of the 102 HIV + women, and all received a pelvic exam that included a conventional Pap smear, a Thinprep test, and colposcopy with directed biopsies and endocervical curettage. A total of 184 women volunteered. 82 were HIV- and 102 were HIV+. The prevalence of CIN in HIV+ women was 37%, more than twice the 17% prevalence of CIN in HIV-women (P = 0.002). When Atypical Squamous Cells of Undetermined Significance (ASCUS) findings were included with "negative" cytology, the conventional Pap smear false negative rates for HIV- and HIV+ women were 21% and 37%, respectively. When ASCUS was included with "positive" cytology, the false negative rates dropped to 14.3% for HIV- women and 10.5% for HIV+ women. We conclude that ASCUS diagnoses comprised the majority of false negatives in HIV+ women.

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“…When we evaluated whether HIV status and immune suppression (CD4≤350) in a male partner increased the risk of a high-grade cervical lesion or cervical cancer in their female sex partner, we found that the risk of abnormal cytology was not significantly increased. However, previous studies have found HIV-infected men with low CD4 T-cell counts to be at greater risk for HPV infection than uninfected men (26, 27), making it plausible that HIV-infected, immunosuppressed men are more likely to transmit HPV to female partners. This merits additional evaluation in studies using HPV genotyping or a larger sample size than was available in this study.…”

Section: Discussionmentioning

confidence: 99%

Individual and partner risk factors associated with abnormal cervical cytology among women in HIV-discordant relationships

et al. 2013

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Individual and sexual partner characteristics may increase risk of abnormal cervical cytology among women in HIV-discordant relationships. Papanicolaou smears were obtained in a prospective cohort of Kenyan HIV-discordant couples. Of 441 women, 283 (64%) were HIV-infected and 158 (36%) were HIV-uninfected with HIV-infected partners. Overall, 79 (18%) had low-grade and 25 (6%) high-grade cervical abnormalities. Lack of male circumcision, male HSV-2 seropositivity and lower couple socioeconomic status were associated with cervical abnormalities (p<0.05). HIV-uninfected women with HIV-infected male sex partners (CD4>350 cells/µL) had the lowest prevalence of high-grade cervical lesions. HIV-infected women (CD4>350 cells/µL) and HIV-uninfected women with HIV-infected partners (CD4≤350 cells/µL) were at similar intermediate risk (P>0.05), and HIV-infected women (CD4≤350 cells/µL) had significantly higher risk of high-grade cervical abnormalities (p=0.05). Women in HIV-discordant relationships have high rates of cervical lesions and this may be influenced by couple-level factors, including HIV status and CD4 count of the infected partner.

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The impact of the human immunodeficiency virus on the human papillomavirus epidemic

Cited by 16 publications

References 0 publications

Lymphoid Follicles Are Generated in High-Grade Cervical Dysplasia and Have Differing Characteristics Depending on HIV Status

Lymphoid Follicles Are Generated in High-Grade Cervical Dysplasia and Have Differing Characteristics Depending on HIV Status

The false negative rate of cervical smears in high risk HIV seropositive and seronegative women

Individual and partner risk factors associated with abnormal cervical cytology among women in HIV-discordant relationships

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