The association between cervical human papillomavirus infection and HIV acquisition among women in Zimbabwe

Abstract

Background The prevalence of HPV is higher among HIV+ women, but the prevalence of HPV prior to HIV acquisition has not been carefully evaluated. Objective This study evaluated whether HPV infection is independently associated with heterosexual HIV acquisition in a cohort of Zimbabwean women. Design Case-control study nested within a large multi-center cohort study (HC-HIV). Methods Cases consisted of Zimbabwean women with incident HIV infection observed during follow-up (n=145). HIV-uninfected controls were selected and matched to cases (n=446). The prevalence of cervical HPV infections was compared at the visit prior to HIV infection in the cases and at the same follow-up visit in the matched controls. Results The odds of acquiring HIV were 2.4 times higher in women with prior cervical HPV infection after adjustment for behavioral and biologic risk factors. There was no statistically significant difference in the risk of HIV acquisition between women infected with high versus low risk HPV types. Loss of detection of at least one HPV DNA type was significantly associated with HIV acquisition (OR =5.4 [95%CI, 2.9–9.9] (p<.0001). Conclusion Cervical HPV infection is associated with HIV acquisition among women residing in a region with a high prevalence of both infections. Further studies are required to evaluate whether the observed association is causal.

Prevalence, Incidence and Risk Factors for Acquisition of Herpes Simplex Virus Type 2 among Fishermen on the Shores of Lake Victoria in Kisumu County, Kenya

“…Therefore, the observed association between persistent HR HPV and new HSV-2 infection warrant further studies and should be interpreted with caution. However, several studies have found that HPV infection increases the risk for HIV acquisition by 1.8 -3.5 times [32]- [34]. Lissouba et al (2013) in their meta-analysis review found that HR HPV infection was associated with almost a 2-fold increased risk for incident HIV infection, while LR HPV infection had only a borderline association [35].…”

Behavioral and biological risks of women seeking HIV test in an anonymous testing center

“…[8][9][10][11] Concordance of biological and behavioral risks was tested by the weighted kappa statistic. 16,17 This study was approved by the institutional ethics committee and followed the Guiding Medical Doctor recommendations of the Biomedical Research Involving Human Subjects and the Declaration of Helsinki.…”

“…[8][9][10][11][12] Clinical conditions like vulvovaginal ulcers, excoriations, cracks, cervicitis, or coinfections (Chlamydia trachomatis, herpes simplex, human papilloma virus -HPV) can all increase the risk of STD/AIDS. [8][9][10][11] Inflammatory nonulcerative genital conditions such as vulvovaginitis, cervicitis and pelvic inflammatory disease have also been shown to be important risk factors. Another consideration is that diagnosis of a sexually transmitted infection should increase suspicion of other STDs.…”

“…Another consideration is that diagnosis of a sexually transmitted infection should increase suspicion of other STDs. [8][9][10][11] The prevalence of HIV infection is increasing among women of all ages and regions, thus reducing the male/female ratio to 3/2. 10 Several epidemiological studies show a growing number of HIV infected women.…”

“…This could be due to untreated genital infections: adequate treatment of such infections would provide the opportunity to restore the vaginal flora as well as the integrity of the genital mucosa, thus reducing the risk of HIV acquisition. 8,9,11 In order to reduce the risk of female HIV infection, several studies have established the necessity of an active search for other parallel diseases, in addition to serological testing and behavioral counseling. 1,2,12,13 In Africa, Laga et al 14 reported that the treatment of genital disorders could reduce the rate of HIV infection in HIV-exposed people.…”