Browsing by Author "Hanh Le Dung Dang"

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    Incidence and Persistence of High-risk Anogenital Human Papillomavirus Infection Among Female Youth With and Without Perinatally Acquired Human Immunodefiency Virus Infection: A 3-year Observational Cohort Study
    (2020-11-05) Nittaya Phanuphak; Sirinya Teeraananchai; 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; Stephen J. Kerr; Annette H. Sohn; Thai Red Cross Agency; Chulalongkorn University; Kirby Institute; Kasetsart University; 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
    © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. BACKGROUND: Female youth with perinatally acquired human immunodeficiency virus (PHIV) may be at higher risk than uninfected youth for persistent anogenital human papillomavirus (HPV) infection, due to prolonged immunodeficiency. METHODS: A 3-year cohort study was conducted between 2013 and 2017 among Thai and Vietnamese PHIV and HIV-uninfected females 12-24 years, matched by age group and number of lifetime sexual partners. For HPV genotyping, cervical and anal samples were obtained at baseline and annually. Vaginal samples were collected at baseline and every 6 months. Factors associated with high-risk HPV (HR-HPV) persistence and incidence were assessed. RESULTS: We enrolled 93 PHIV and 99 HIV-uninfected females. Median age was 19 (interquartile range [IQR] 18-20) years. For the 7 HR-HPV types (16, 18, 31, 33, 45, 52, 58) in the nonavalent HPV vaccine, PHIV had significantly higher incidence (P = .03) and persistence (P = .01) than HIV-uninfected youth over a 3-year period. Having HIV (adjusted hazard ratio [aHR] 2.1, 95% confidence interval [CI] 1.1-3.9) and ever using illegal substances (aHR 4.8, 95% CI 1.8-13.0) were associated with incident 7 HR-HPV infections. HIV-positive status (adjusted prevalence ratio [aPR] 2.2, 95% CI 1.5-3.2), recent alcohol use (aPR 1.75, 95% CI 1.2-2.5), and higher number of lifetime partners (aPR 2.0, 95% CI 1.4-3.1, for 3-5 partners; aPR 1.93, 95% CI 1.2-3.2, for ≥6 partners) were significantly associated with persistent 7 HR-HPV infections. CONCLUSIONS: Female PHIV were at higher risk of having anogenital HR-HPV acquisition and persistence. Primary and secondary prevention programs for HPV infection and HPV-related diseases should be prioritized for PHIV children and youth.
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    Increased Burden of Concordant and Sequential Anogenital Human Papillomavirus Infections Among Asian Young Adult Women With Perinatally Acquired HIV Compared With HIV-Negative Peers
    (2021-03-01) Annette H. Sohn; Amphan Chalermchockcharoenkit; Sirinya Teeraananchai; Rawiwan Hansudewechakul; Sivaporn Gatechompol; Kulkanya Chokephaibulkit; Hanh Le Dung Dang; Dan Ngoc Hanh Tran; Jullapong Achalapong; Nipat Teeratakulpisarn; Manopchai Thamkhantho; Nittaya Phanuphak; Jintanat Ananworanich; Peter Reiss; Stephen J. Kerr; Siriraj Hospital; Thai Red Cross Agency; Universiteit van Amsterdam; From The Foundation for AIDS Research; Hung Vuong Hospital; Children's Hospital 1; Chiangrai Prachanukroh Hospital
    BACKGROUND: Youth with perinatally acquired HIV (YPHIV) are at higher risk for anogenital human papillomavirus (HPV) infection. METHODS: We enrolled a cohort of YPHIV and HIV-negative youth in Thailand and Vietnam, matched by age and lifetime sex partners, and followed them up for 144 weeks (to 2017). Participants had annual pelvic examinations with samples taken for HPV genotyping. Concordant infection was simultaneous HPV detection in multiple anogenital compartments (cervical, vaginal, anal); sequential infection was when the same type was found in successive compartments (cervicovaginal to/from anal). Generalized estimating equations were used to assess factors associated with concordant infection, and Cox regression was used to assess factors associated with sequential infection. RESULTS: A total of 93 YPHIV and 99 HIV-negative women were enrolled, with a median age of 19 years (interquartile range, 18-20 years). High-risk anogenital HPV infection was ever detected in 76 (82%) YPHIV and 66 (67%) HIV-negative youth during follow-up. Concordant anogenital high-risk HPV infection was found in 62 (66%) YPHIV versus 44 (34%) HIV-negative youth. Sequential cervicovaginal to anal high-risk HPV infection occurred in 20 YPHIV versus 5 HIV-negative youth, with an incidence rate of 9.76 (6.30-15.13) versus 2.24 (0.93-5.38) per 100 person-years. Anal to cervicovaginal infection occurred in 4 YPHIV versus 0 HIV-negative women, with an incidence rate of 1.78 (0.67-4.75) per 100 person-years. Perinatally acquired HIV was the one factor independently associated with both concordant and sequential high-risk HPV infection. CONCLUSIONS: Children and adolescents with perinatally acquired HIV should be prioritized for HPV vaccination, and cervical cancer screening should be part of routine HIV care for sexually active YPHIV.
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    Prevalence of high-risk nonavalent vaccine-type human papillomavirus infection among unvaccinated, sexually active asian female adolescents with and without perinatally acquired HIV infection
    (2020-01-01) Sirintip Sricharoenchai; Stephen J. Kerr; Stephen J. Kerr; Sivaporn Gatechompol; Rawiwan Hansudewechakul; Hanh Le Dung Dang; Dan Ngoc Hanh Tran; Nipat Teeratakulpisarn; Amphan Chalermchockcharoenkit; Jullapong Achalapong; Sirinya Teeraananchai; Thida Singtoroj; Nittaya Phanuphak; Annette H. Sohn; Kulkanya Chokephaibulkit; Thai Red Cross Agency; Chulalongkorn University; Kasetsart University; The HIV Netherlands Australia Thailand Research Collaboration; Faculty of Medicine, Siriraj Hospital, Mahidol University; Children's Hospital 1; Foundation for AIDS Research; Chiangrai Prachanukroh Hospital; Hung Vuong Hospital
    © 2020 Wolters Kluwer Health, Inc. All rights reserved. Background: We studied the prevalence of 7, high-risk human papillomavirus (HPV) types in the nonavalent vaccine (HRVT-7: HPV 16, 18, 31, 33, 45, 52, 58) among vaccine-naïve, sexually active Asian female adolescents with and without perinatally acquired HIV infection (PHIV). Methods: PHIV female adolescents 12-24 years of age and HIV-uninfected controls matched by age and number of lifetime sex partners were enrolled in a 3-year observational cohort study in Thailand and Vietnam. Samples from the oral cavity, anus, cervix and vagina were collected for HRVT-7 HPV genotyping, and serum collected for HPV 16 and 18 antibody testing. Baseline data were analyzed using multivariable logistic regression. Results: We included 93 PHIV (median CD4 593 cells/mm3, 62% with HIV RNA suppression) and 99 HIV-uninfected adolescents (median lifetime sex partners 2). The overall prevalence of HRVT-7 infection was 53% in PHIV and 49% in HIV-uninfected adolescents (P = 0.66). Cervical HRVT-7 DNA was detected more frequently in PHIV than HIV-uninfected adolescents (37% vs. 23%, P = 0.04). Overall, more lifetime partners [≥3 vs. 1; odds ratio (OR) 2.99 (1.38-6.51), P = 0.02] and having other sexually transmitted infections [OR 3.30 (1.51-7.21), P = 0.003] increased the risk of HRVT-7 infection and/or positive HPV 16/18 antibodies; while detectable HIV RNA [OR 2.78 (1.05-7.36), P = 0.04] increased the risk among PHIV adolescents. Conclusions: Half of sexually active Asian female adolescents, regardless of HIV infection, had already acquired HRVT-7 infection. This underscores the need for earlier access to HPV vaccine in the region.
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    Risk factors for human papillomavirus infection and abnormal cervical cytology among perinatally human immunodeficiency virus-infected and uninfected asian youth
    (2018-01-01) 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
    © 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.