AEGiS-15IAC: Prevalence of human papilloma virus (HPV) DNA in women who are antiretroviral-naïve and initiating highly active antiretroviral therapy (HAART): baseline (BL) analysis of A5029.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Prevalence of human papilloma virus (HPV) DNA in women who are antiretroviral-naïve and initiating highly active antiretroviral therapy (HAART): baseline (BL) analysis of A5029.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThPeA6952)

Squires KE, Nyangweso PM, Brown D, Fife K, Clark R, Watts H, Hafner R, Bernstein S, Andersen JW; Keck School of Medicine USC, Los Angeles, United States

BACKGROUND: A5029 was designed to determine the effect of HAART on HPV status and course of cervical dysplasia in ART-naïve, HIV-1 infected subjects (sbjs). We present BL characteristics of the sbjs and their association with HPV DNA, HPV risk level and Papanicolaou smear status.

METHODS: Previously untreated sbjs initiating HAART undergo history and physical, cervical brush for HPV DNA by PCR, Pap smear and phlebotomy for CD4 cell count and plasma HIV-1 RNA at BL, wks 24, 48 and yearly. HPV status is defined as high risk (HR) [at least one high risk HPV type], low risk (LR) [only one or more low risk HPV type] or none. Pap smears, reviewed by a central reader, are classified as normal or abnormal. Analyses were performed with Fisher's Exact and Wilcoxon tests.

RESULTS: 147 sbjs enrolled; BL characteristics for 146 with HPV data: 45% black (B), 34% Latina (L), 16% white (W); median CD4 239 cells/mm³ (c/mm³) and plasma HIV-1 RNA 26,396 copies/mL. HPV DNA, detected in 96/146 (66% [95% CI: 57.4%, 73.4%]) cervical specimens, was significantly associated with CD4 c/mm³ [215 in HPV DNA (+) vs 311 in HPV DNA (-) (p=0.042)]. HR HPV types, present in 89/146 (61%) cervical specimens, were detected more often in sbjs with history of (p=0.075) or current (p=0.082) smoking. Abnormal Pap smears, reported in 49/146 (34%) sbjs, were significantly associated with race/ethnicity [58% W, 35% B, 18% L (p=0.004)], previous treatment for abnormal Pap smear and gyn surgery (p<0.001) and marginally with current smoking (p=0.052). Plasma HIV-1 RNA level was not associated with HPV DNA detection, HPV risk type or abnormal Pap smears (all p>0.20).

CONCLUSIONS: Cervical HPV infection is common in HIV-infected women initiating HAART therapy. Detection of cervical HPV DNA is associated with immune status and behavioral and gynecologic factors. Abnormal Pap smears are associated with behavioral and gynecologic factors but not immune status.

Keywords: AEGIS, Papillomavirus, Human, Antiretroviral Therapy, Highly Active, Prevalence, Vaginal Smears, DNA, Viral, Glass Ionomer Cements, DNA, HIV-1, CD4 Lymphocyte Count, Polymerase Chain Reaction, HIV Seropositivity, Carcinoma in Situ, BaseLine, Humans, Female, analysis, epidemiology

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