Racial differences in human papilloma virus types amongst United States women with HIV and cervical precancer
Year: 2018
Type: article
Abstract: OBJECTIVE: Recent studies reported a lower human papillomavirus 16 (HPV16) prevalence in cervical precancer among African American than Caucasian women in the general population. We assessed this relationship in women with HIV. DESIGN: Women living with or at risk for HIV in the Women's Interagency HIV Study were followed semi-annually with Pap tests, colposcopy/histology (if indicated), and collection of cervicovaginal lavage samples for HPV testing by PCR. Racial and ethnic groups were defined using genomic Ancestry Informative Markers (AIMs). RESULTS: Among 175 cases of cervical intraepithelial neoplasia 3 or worse (CIN-3+), 154 were diagnosed in women with HIV. African American (27%) and Hispanic (37%) cases were significantly less likely than Caucasian (62%) women to test positive for HPV16 (P = 0.01). In multivariate logistic regression models, these associations remained significant for African Americans (odds ratio = 0.13; 95% confidence interval (CI) 0.04-0.44; P = 0.001) but not Hispanics, after controlling for HIV status, CD4 count, history of AIDS, age, smoking, and sexual behavior. Limiting the analysis to women with HIV did not change the findings. CONCLUSION: HPV16 prevalence is lower in African American compared with Caucasian women with HIV and cervical precancer, independent of immune status. Future studies to determine why these racial differences exist are warranted, and whether there are similar associations between race and invasive cervical cancer in women with HIV. Further, HPV types not covered by quadrivalent and bivalent vaccines may play an especially important role in cervical precancer among HIV-positive African American women, a possible advantage to using nonavalent HPV vaccine in this population.
Source: AIDS
Institutions: Albert Einstein College of Medicine, Montefiore Medical Center, Washington University in St. Louis, University of Alabama at Birmingham, University of California, San Francisco, Maimonides Medical Center, Pfizer (United States), University at Albany, State University of New York, Johns Hopkins University, Georgetown University Medical Center, New York University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Georgia Clinical and Translational Science Alliance, National Institutes of Health, University of California, San Francisco, National Institute on Alcohol Abuse and Alcoholism, National Institute on Aging, National Institute of Mental Health, National Institute on Drug Abuse, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, National Institute of Dental and Craniofacial Research, Office of Research on Women's Health, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Center for AIDS Research, University of North Carolina at Chapel Hill
Awards: G2117662475, G2227505777, Acute Effects of Cannabis on Cognition and Mobility in Older HIV-Infected and Uninfected Women", Emory WIHS CRS - Longitudinal Cohort, G2638674773, HPV & Cervix Neoplasia in a Large, Long Term HIV + Cohort, G311558797, Next Generation of HPV and Cervical Cancer Research in HIV+ Women, The Connie Wofsy Women's HIV Study, Brooklyn Women's Interagency HIV Study (WIHS) V, Miami Womens Interagency HIV Study WIHS, G4371267688, WIHS Data Management and Analysis Center (WDMAC), Southern California Women's Interagency HIV Study Consortium, Molecular Methods to Improve Cervical Cancer Screening in HIV+ Women, Chicago WIHS Consortium V (CWC), Washington Women's Interagency HIV/AIDS Study, Clinical and Translational Science Institute, G5900455136, Atlanta Clinical and Translational Science Institute (ACTSI) Renewal, G6300780520, G6384504179, G6990385686, University of North Carolina Womens Interagency HIV Study UNC WIHS, G767062161, G775892330, G7807729167, Women's Interagency HIV Study (WIHS-V), G8846374971, UAB-MISS WIHS Cohort, G9000080293, G9000122276, Cancer Center Support Grant, The University of North Carolina Center for AIDS Research
OpenAlex ID: W2922345469