Genital Tract HIV RNA Levels and Their Associations With Human Papillomavirus Infection and Risk of Cervical Precancer
Year: 2014
Type: article
Study design: Observational Study
Abstract: OBJECTIVE: Plasma HIV RNA levels have been associated with the risk of human papillomavirus (HPV) and cervical neoplasia in HIV-seropositive women. However, little is known regarding local genital tract HIV RNA levels and their relation with cervical HPV and neoplasia. DESIGN/METHODS: In an HIV-seropositive women's cohort with semiannual follow-up, we conducted a nested case-control study of genital tract HIV RNA levels and their relation with incident high-grade squamous intraepithelial lesions (HSIL) subclassified as severe (severe HSIL), as provided for under the Bethesda 2001 classification system. Specifically, 66 incidents of severe HSIL were matched to 130 controls by age, CD4 count, highly active antiretroviral therapy use, and other factors. We also studied HPV prevalence, incident detection, and persistence in a random sample of 250 subjects. RESULTS: Risk of severe HSIL was associated with genital tract HIV RNA levels (odds ratio comparing HIV RNA ≥ the median among women with detectable levels versus undetectable, 2.96; 95% confidence interval: 0.99 to 8.84; Ptrend = 0.03). However, this association became nonsignificant (Ptrend = 0.51) after adjustment for plasma HIV RNA levels. There was also no association between genital tract HIV RNA levels and the prevalence of any HPV or oncogenic HPV. However, the incident detection of any HPV (Ptrend = 0.02) and persistence of oncogenic HPV (Ptrend = 0.04) were associated with genital tract HIV RNA levels, after controlling plasma HIV RNA levels. CONCLUSIONS: These prospective data suggest that genital tract HIV RNA levels are not a significant independent risk factor for cervical precancer in HIV-seropositive women, but they leave open the possibility that they may modestly influence HPV infection, an early stage of cervical tumorigenesis.
Authors: Jeny Ghartey, Andrea Kovacs, Robert D. Burk, L. Stewart Massad, Howard Minkoff, Xianhong Xie, Gypsyamber D'souza, Xiaonan Xue, D. Heather Watts, Alexandra M. Levine, Mark H. Einstein, Christine Colie, Kathryn Anastos, Isam-Eldin Eltoum, Betsy C. Herold, Joel M. Palefsky, Howard D. Strickler
Institutions: University of Southern California, Albert Einstein College of Medicine, City Of Hope National Medical Center, Maimonides Medical Center, Montefiore Medical Center, Georgetown University, Georgetown University Medical Center, Washington University in St. Louis, Johns Hopkins University, National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, University of Alabama at Birmingham, University of California, San Francisco
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: National Institutes of Health, U.S. Public Health Service, National Cancer Institute, National Institute of Allergy and Infectious Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1089263533, G1252706584, G1383752764, Clinical and Translational Science Institute, G2117662475, G2574405597, G2674972404, HPV & Cervix Neoplasia in a Large, Long Term HIV + Cohort, The Connie Wofsy Women's HIV Study, Brooklyn Women's Interagency HIV Study (WIHS) V, G3513993426, Clinical and Translational Science Award-K12, Center for AIDS Research (CFAR), WIHS Data Management and Analysis Center (WDMAC), G499585988, Chicago WIHS Consortium V (CWC), Washington Women's Interagency HIV/AIDS Study, Clinical and Translational Science Institute, G592158972, Clinical and Translational Science Award, Novel Mucosal Models Predictive of Microbicide Safety, G7299699879, G826976987, G925273713, G986692823
OpenAlex ID: W2039366016