Rates and determinants of incidence and clearance of cervical HPV genotypes among HIV-seropositive women in Pune, India.
BACKGROUND
Several studies in recent years have documented the genotype-specific prevalence of HPV infection and wide diversity and multiplicity of HPV genotypes among HIV-seropositive women. Yet, information on changes in HPV genotype-specific incidence and clearance rates over time, and their correlation with clinical or immunologic factors among HIV-seropositive women is scarce.


OBJECTIVES
We conducted a prospective study to investigate the incidence and clearance rates of cervical HPV genotypes among HIV-seropositive women in India and expand the evidence base in this area of research.


STUDY DESIGN
Cervical samples were collected from n=215 HIV-seropositive women in Pune, India who underwent two screening visits separated by a median of 11-months (interquartile range: 8-18 months). HPV genotypes were determined by Roche Linear Array HPV assay. Individual genotype-specific and carcinogenicity-grouping-specific HPV incidence and clearance rates were calculated and the associations between incidence/clearance and age and HIV-related metrics were explored.


RESULTS
Incidence and clearance rates for 'any HPV' and 'carcinogenic HPV' genotypes were 11.1 and 18.3, and 6.7 and 33.8, per 100 person-years, respectively. Incidence and clearance rates for HPV genotypes of alpha-9 species (HPV16, HPV31, HPV33, HPV35, HPV52 and HPV58) and alpha-7 species (HPV18, HPV39, HPV45, HPV59 and HPV68) were 5.8 and 2.04, and 32.1 and 53.5, per 100 person-years, respectively. Clearance of any HPV type was associated with increasing age of participants (odds ratio: 1.08, 95%CI: 1.004-1.17), although the association marginally lost its statistical significance when adjusted for CD4 counts and antiretroviral therapy status.


CONCLUSIONS
Genotype-specific clearance rates of HPV were higher than corresponding incidence rates. The suggestion of a positive associations of increasing age with HPV clearance points to the need for etiologic studies on age-related hormonal changes on clearance of cervical HPV infection.
['Mane|Arati|A|', 'Sahasrabuddhe|Vikrant V|VV|', 'Nirmalkar|Amit|A|', 'Risbud|Arun R|AR|', 'Sahay|Seema|S|', 'Bhosale|Ramesh A|RA|', 'Vermund|Sten H|SH|', 'Mehendale|Sanjay M|SM|']
D000328:Adult D002584:Cervix Uteri D005260:Female D005838:Genotype D015658:HIV Infections D006801:Humans D015994:Incidence D007194:India D027383:Papillomaviridae D030361:Papillomavirus Infections D011446:Prospective Studies
Incidence Clearance HPV Genotypes HIV Natural history