Frequent Detection of HPV before and after Initiation of Antiretroviral Therapy among HIV/HSV-2 Co-Infected Women in Uganda
Identifieur interne : 000348 ( Main/Exploration ); précédent : 000347; suivant : 000349Frequent Detection of HPV before and after Initiation of Antiretroviral Therapy among HIV/HSV-2 Co-Infected Women in Uganda
Auteurs : Anne F. Rositch [États-Unis] ; Patti E. Gravitt [États-Unis, Malaisie] ; Aaron A. R. Tobian [États-Unis] ; Kevin Newell ; Thomas C. Quinn [États-Unis] ; David Serwadda [Ouganda] ; Paschal Ssebbowa [Ouganda] ; Valerian Kiggundu [Ouganda] ; Ronald H. Gray [États-Unis, Ouganda] ; Steven J. Reynolds [Ouganda, États-Unis]Source :
- PLoS ONE [ 1932-6203 ] ; 2013.
Abstract
Most data on HPV and antiretroviral therapy (ART) come from high-resource countries with infrequent sampling for HPV pre- and post-ART initiation. Therefore, we examined the frequency of cervical HPV DNA detection among HIV/HSV-2 co-infected women followed monthly for 6 months both before and after initiation of ART in Rakai, Uganda.
Linear Array was used to detect 37 HPV genotypes in self-collected cervicovaginal swabs from 96 women who initiated ART. Random-effects log-binomial regression was used to compare the prevalence of HPV detection in the pre- and post-ART periods and determine other potential risk factors, including CD4 counts and HIV viral load.
Nearly all women had detectable HPV in the 6 months preceding ART initiation (92%) and the cumulative prevalence remained high following initiation of therapy (90%). We found no effect of ART on monthly HPV DNA detection (prevalence ratio: 1.0; 95% confidence interval: 0.96, 1.08), regardless of immune reconstitution or HIV viral suppression. Older age and higher pre-ART CD4 counts were associated with a significantly lower risk of HPV DNA detection.
ART did not impact HPV detection within 6 months of therapy initiation, highlighting the importance of continued and consistent screening, even after ART-initiation and immune reconstitution.
Url:
DOI: 10.1371/journal.pone.0055383
PubMed: 23383171
PubMed Central: 3558485
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec><title>Objectives</title>
<p>Most data on HPV and antiretroviral therapy (ART) come from high-resource countries with infrequent sampling for HPV pre- and post-ART initiation. Therefore, we examined the frequency of cervical HPV DNA detection among HIV/HSV-2 co-infected women followed monthly for 6 months both before and after initiation of ART in Rakai, Uganda.</p>
</sec>
<sec><title>Methods</title>
<p>Linear Array was used to detect 37 HPV genotypes in self-collected cervicovaginal swabs from 96 women who initiated ART. Random-effects log-binomial regression was used to compare the prevalence of HPV detection in the pre- and post-ART periods and determine other potential risk factors, including CD4 counts and HIV viral load.</p>
</sec>
<sec><title>Results</title>
<p>Nearly all women had detectable HPV in the 6 months preceding ART initiation (92%) and the cumulative prevalence remained high following initiation of therapy (90%). We found no effect of ART on monthly HPV DNA detection (prevalence ratio: 1.0; 95% confidence interval: 0.96, 1.08), regardless of immune reconstitution or HIV viral suppression. Older age and higher pre-ART CD4 counts were associated with a significantly lower risk of HPV DNA detection.</p>
</sec>
<sec><title>Conclusions</title>
<p>ART did not impact HPV detection within 6 months of therapy initiation, highlighting the importance of continued and consistent screening, even after ART-initiation and immune reconstitution.</p>
</sec>
</div>
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