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To evaluate the fraction of invasive cervical carcinoma (ICC) that could be prevented in HIV-infected women by vaccines currently available against human papillomavirus (HPV)16 and 18, we conducted a cross-sectional study in women with ICC in Nairobi, Kenya. Fifty-one HIV-positive women were frequency-matched by age to 153 HIV-negative women. Cervical cells were tested for HPV DNA using polymerase chain reaction-based assays (SPF10-INNO-LiPA). Comparisons were adjusted for multiplicity of HPV types. As expected, multiple-type infections were much more frequent in HIV-positive (37.2%) than in HIV-negative (13.7%) women, but the distribution of HPV types was similar. HPV16 was detected in 41.2% versus 43.8% and HPV16 and/or 18 in 64.7% versus 60.1% of HIV-positive versus HIV-negative women, respectively. The only differences of borderline statistical significance were an excess of HPV52 (19.6% versus 5.2%) and a lack of HPV45 (7.8% versus 17.0%) in HIV-positive women compared to HIV-negative women, respectively. We have been able to assess an unprecedented number of ICCs in HIV-positive women, but as we did not know the age of HIV acquisition, we cannot exclude that it had occurred too late in life to affect the type of HPV involved in cervical carcinogenesis. However, if our findings were confirmed, they would suggest that the efficacy of current vaccines against HPV16 and 18 to prevent ICC is similar in HIV-positive and HIVnegative women, provided vaccination is administered before sexual debut, as recommended. ' 2007 Wiley-Liss, Inc.Key words: HIV; cervical cancer; human papillomavirus; polymerase chain reaction; AfricaThe main cause of invasive cervical carcinoma (ICC) is infection with high-risk human papillomavirus (HPV), most notably HPV16 and 18, which have been detected in approximately 70% of ICC in all world regions. 1 Newly developed vaccines have been shown to be highly efficacious in preventing infection with these HPV types and routine vaccination of adolescent women is now being recommended. 2 Women infected with HIV are at increased risk of HPV infection 3 and development of precancerous and cancerous lesions of the cervix. 4 Furthermore, a large systematic review of HIV-positive women with normal cytology, low-grade and high-grade intraepithelial lesions has shown that HPV16 is relatively under-represented when compared to HIV-negative women. 3 This difference has been attributed to the fact that clearance of HPV16 is less dependent on an individual's immune status than clearance of other high-risk types, as shown in HIV-positive women. 5 Information on HPV types in ICC has been reported, however, in only 14 HIV-positive women. 3 We have therefore carried out a comparison of the distribution of HPV types in ICC in women with and without HIV in Kenya, a country hit hard by the HIV epidemic (www.unaids.org/en/Regions_Countries/Countries/ kenya.asp). MethodsBetween January 2000 and March 2002, we identified and obtained informed consent from 367 women with ICC (i.e., 96% of those eligible) who pres...

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