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Persistance of HPV in HIV+ Adolescent Girls
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"Persistence of Human Papillomavirus Infection in HIV-Infected and -Uninfected Adolescent Girls: Risk Factors and Differences, by Phylogenetic Type"
Journal of Infectious Diseases
July 2004, Vol. 90
Anna-Barbara Moscicki; Jonas H. Ellenberg; Sepideh Farhat
High rates of persistence of human papillomavirus (HPV) infection have been reported for adult women with HIV infection. Although most women are first infected with HPV during adolescence, persistence of specific HPV types has not been carefully examined among HIV-infected adolescents.
To examine the rates of and risk factors for persistence of HPV types among HIV-infected and -uninfected adolescent girls, the researchers conducted a prospective cohort study of female adolescents, ages 13-18, participating in the Reaching for Excellence in Adolescent Care and Health Project, a national study of HIV-infected and -uninfected adolescents.
The main outcome measure was type-specific loss of initial HPV DNA detected. The investigators found prevalent or incident HPV infection in 334 girls. When type-specific loss of HPV was examined, the researchers found that HIV-uninfected girls had a shorter mean time to loss of initial infection than HIV-infected girls (403 days vs. 689 days, respectively). Using multivariate analysis, the authors found CD4 immunosuppression and the presence of multiple HPV-type subgroups to be associated with the persistence of HPV.
"Since the persistence of high-risk HPV types has been strongly linked with the development of invasive cancer, the prolonged persistence of HPV observed among HIV-infected adolescents who are relatively healthy underscores the importance of prevention of HPV infection in this group," the authors concluded.
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