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Title: Risk factors for human papillomavirus infection and abnormal cervical cytology among perinatally human immunodeficiency virus-infected and uninfected asian youth
Authors: Annette H. Sohn
Stephen J. Kerr
Rawiwan Hansudewechakul
Sivaporn Gatechompol
Kulkanya Chokephaibulkit
Hanh Le Dung Dang
Dan Ngoc Hanh Tran
Jullapong Achalapong
Nipat Teeratakulpisarn
Amphan Chalermchockcharoenkit
Manopchai Thamkhantho
Tippawan Pankam
Thida Singtoroj
Wichai Termrungruanglert
Surasith Chaithongwongwatthana
Nittaya Phanuphak
Chulalongkorn University
Kirby Institute
The HIV Netherlands Australia Thailand Research Collaboration
Faculty of Medicine, Siriraj Hospital, Mahidol University
Children's Hospital 1
TREAT Asia/amfAR-The Foundation for AIDS Research
Chiangrai Prachanukroh Hospital
Hung Vuong Hospital
Keywords: Medicine
Issue Date: 1-Jan-2018
Citation: Clinical Infectious Diseases. Vol.67, No.4 (2018), 606-613
Abstract: © The Author(s) 2018. Background. Infection with high-risk human papillomavirus (HR-HPV) may be higher in perinatally human immunodeficiency virus (HIV)-infected (PHIV) than HIV-uninfected (HU) adolescents because of long-standing immune deficiency. Methods. PHIV and HU females aged 12-24 years in Thailand and Vietnam were matched by age group and lifetime sexual partners. At enrollment, blood, cervical, vaginal, anal, and oral samples were obtained for HPV-related testing. The Wilcoxon and Fisher exact tests were used for univariate and logistic regression for multivariate analyses. Results. Ninety-three PHIV and 99 HU adolescents (median age 19 [18-20] years) were enrolled (June 2013-July 2015). Among PHIV, 94% were currently receiving antiretroviral therapy, median CD4 count was 593 (392-808) cells/mm3, and 62% had a viral load <40 copies/mL. Across anogenital compartments, PHIV had higher rates of any HPV detected (80% vs 60%; P =.003) and any HR-HPV (60% vs 43%, P =.02). Higher proportions of PHIV had abnormal Pap smears (eg, atypical squamous cells of unknown significance [ASC-US], 12% vs 14%; low-grade squamous intraepithelial neoplastic lesions, 19% vs 1%). After adjusting for ever being pregnant and asymptomatic sexually transmitted infections (STI) at enrollment, PHIV were more likely to have HR-HPV than HU (odds ratio, 2.02; 95% confidence interval, 1.09-3.77; P =.03). Conclusions. Perinatal HIV infection was associated with a higher risk of HR-HPV and abnormal cervical cytology. Our results underscore the need for HPV vaccination for PHIV adolescents and for prevention and screening programs for HPV and other STIs.
ISSN: 15376591
Appears in Collections:Scopus 2018

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