*Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati College of Medicine, Cincinnati, OH †Departments of Pediatrics, Microbiology and Immunology, Obstetrics and Gynecology and Women's Health, and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY ‡Department of Medicine, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA §Pediatric, Adolescent and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD ||Department of Pediatrics, New York University School of Medicine, New York, NY ¶Westat, Rockville, MD #Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL. JAIDS Journal of Acquired Immune Deficiency Syndromes
(Impact Factor: 4.56).
07/2012; 61(3):390-399. DOI: 10.1097/QAI.0b013e3182676fe3
The objectives of this study were to describe the prevalence and risk factors for HPV infection among HIV-infected young women receiving their first quadrivalent HPV (HPV-6, -11, -16, and -18) vaccine dose.
We recruited 16- to 23-year-old women from 14 sites for an HPV vaccine trial. At the first visit, they completed a questionnaire and were tested for cervicovaginal HPV DNA (41 types) and HPV serology (4 vaccine types). Factors associated with any HPV, type-specific HPV, and high-risk (cancer-associated) HPV infections were identified using univariate and multivariable logistic regression.
The mean age of participants (N = 99) was 21.4 years, 30.3% were on antiretroviral therapy, 74.7% were positive for ≥1 HPV DNA type, 53.5% for ≥1 high-risk type, 12.1% for HPV-16, and 5.1% for HPV-18. Most were HPV DNA negative and seronegative for HPV-16 (55.6%) and HPV-18 (73.7%); 45.5% were HPV DNA negative and seronegative for both HPV-16 and -18. Three variables were associated with high-risk HPV DNA in multivariable analysis: non-Hispanic black versus Hispanic ethnicity (adjusted odds ratio [AOR]: 7.06, 95% CI: 1.63 to 30.5), HIV viral load ≥ 400 versus <400 copies/mL (AOR: 3.47, 95% CI: 1.28 to 9.43), and frequency of vaginal sex in the past 90 days (AOR: 5.82, 95% CI: 1.30 to 26.11 for ≥6 vs 0 times).
The prevalence of ≥1 HPV type was high in these young women, demonstrating the importance of vaccinating before sexual initiation. However, most women were HPV DNA negative and seronegative for high-risk vaccine-type HPV infection, supporting vaccination of sexually experienced HIV-positive young women.