BACKGROUND: The Canadian Women's HIV Study (CWHS) enrolled human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women in a longitudinal cohort. This analysis considered the effects of HIV and highly active antiretroviral therapy (HAART) on HPV persistence and cervical squamous intraepithelial lesions (SILs). METHODS: Longitudinal cytopathologic and HPV DNA results were analyzed using multistate models. States of cervical SIL were defined as absent, present, and treatment; HPV states were defined as negative or positive. Demographic variables and markers of sexual activity were considered predictors. Results were calculated on the basis of transition probabilities and reported as hazard ratios (HRs). RESULTS: The CWHS followed 750 HIV-positive and 323 HIV-negative women during 1993-2002. A total of 467 and 456 women were included in the longitudinal cervical cytopathologic and HPV DNA analyses, respectively. HIV-positive women had increased prevalence (46.6% vs 28.7%; P < .0001), increased acquisition (HR, 2.3; P = .03), and decreased clearance (HR, 0.4; P < .001) of oncogenic HPV as compared to HIV-negative women. Oncogenic HPV infection predicted progression of cervical dysplasia from normal to abnormal SIL (HR, 2.8; P = .002). Among HIV-positive participants, HAART increased the likelihood of regression (from present to absent) of cervical SIL (HR, 3.3; P = .02) and increased the clearance of oncogenic HPV types other than HPV-16 or HPV-18 (HR, 2.2; P = .01). CONCLUSIONS: This analysis demonstrated beneficial effects of HAART on cervical SIL in HIV-positive women.
BACKGROUND: The Canadian Women's HIV Study (CWHS) enrolled human immunodeficiency virus (HIV)-positive and high-risk HIV-negative women in a longitudinal cohort. This analysis considered the effects of HIV and highly active antiretroviral therapy (HAART) on HPV persistence and cervical squamous intraepithelial lesions (SILs). METHODS: Longitudinal cytopathologic and HPV DNA results were analyzed using multistate models. States of cervical SIL were defined as absent, present, and treatment; HPV states were defined as negative or positive. Demographic variables and markers of sexual activity were considered predictors. Results were calculated on the basis of transition probabilities and reported as hazard ratios (HRs). RESULTS: The CWHS followed 750 HIV-positive and 323 HIV-negative women during 1993-2002. A total of 467 and 456 women were included in the longitudinal cervical cytopathologic and HPV DNA analyses, respectively. HIV-positive women had increased prevalence (46.6% vs 28.7%; P < .0001), increased acquisition (HR, 2.3; P = .03), and decreased clearance (HR, 0.4; P < .001) of oncogenic HPV as compared to HIV-negative women. Oncogenic HPV infection predicted progression of cervical dysplasia from normal to abnormal SIL (HR, 2.8; P = .002). Among HIV-positive participants, HAART increased the likelihood of regression (from present to absent) of cervical SIL (HR, 3.3; P = .02) and increased the clearance of oncogenic HPV types other than HPV-16 or HPV-18 (HR, 2.2; P = .01). CONCLUSIONS: This analysis demonstrated beneficial effects of HAART on cervical SIL in HIV-positive women.
Authors: Dmitri Madera; Lynn Vitale-Cross; Daniel Martin; Abraham Schneider; Alfredo A Molinolo; Nitin Gangane; Thomas E Carey; Jonathan B McHugh; Christine M Komarck; Heather M Walline; William N William; Raja R Seethala; Robert L Ferris; J Silvio Gutkind Journal: Cancer Prev Res (Phila) Date: 2015-02-13
Authors: Daniel C Beachler; Elizabeth A Sugar; Joseph B Margolick; Kathleen M Weber; Howard D Strickler; Dorothy J Wiley; Ross D Cranston; Robert D Burk; Howard Minkoff; Susheel Reddy; Weihong Xiao; Yingshi Guo; Maura L Gillison; Gypsyamber D'Souza Journal: Am J Epidemiol Date: 2014-12-04 Impact factor: 4.897
Authors: Scott Dryden-Peterson; Memory Bvochora-Nsingo; Gita Suneja; Jason A Efstathiou; Surbhi Grover; Sebathu Chiyapo; Doreen Ramogola-Masire; Malebogo Kebabonye-Pusoentsi; Rebecca Clayman; Abigail C Mapes; Neo Tapela; Aida Asmelash; Heluf Medhin; Akila N Viswanathan; Anthony H Russell; Lilie L Lin; Mukendi K A Kayembe; Mompati Mmalane; Thomas C Randall; Bruce Chabner; Shahin Lockman Journal: J Clin Oncol Date: 2016-11-01 Impact factor: 44.544
Authors: Howard D Strickler; Jeffrey Martinson; Seema Desai; Xianhong Xie; Robert D Burk; Kathryn Anastos; L Stewart Massad; Howard Minkoff; Xiaonan Xue; Gypsyamber D'Souza; Alexandra M Levine; Christine Colie; D Heather Watts; Joel M Palefsky; Alan Landay Journal: Viral Immunol Date: 2014-02 Impact factor: 2.257