The impact of highly active antiretroviral therapy on prevalence and incidence of cervical human papillomavirus infections in HIV-positive adolescents
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Shrestha, Sadeep, et al. The Impact of Highly Active Antiretroviral Therapy On Prevalence and Incidence of Cervical Human Papillomavirus Infections In Hiv-positive Adolescents. BioMed Central Ltd, 2010. https://doi.org/10.17615/m91f-zq67APA
Shrestha, S., Sudenga, S., Smith, J., Bachmann, L., Wilson, C., & Kempf, M. (2010). The impact of highly active antiretroviral therapy on prevalence and incidence of cervical human papillomavirus infections in HIV-positive adolescents. BioMed Central Ltd. https://doi.org/10.17615/m91f-zq67Chicago
Shrestha, Sadeep, Staci L Sudenga, Jennifer Smith, Laura H Bachmann, Craig M Wilson, and Mirjam C Kempf. 2010. The Impact of Highly Active Antiretroviral Therapy On Prevalence and Incidence of Cervical Human Papillomavirus Infections In Hiv-Positive Adolescents. BioMed Central Ltd. https://doi.org/10.17615/m91f-zq67- Creator
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Shrestha, Sadeep
- Other Affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Sudenga, Staci L
- Other Affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Smith, Jennifer
- Affiliation: Gillings School of Global Public Health, Department of Epidemiology
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Bachmann, Laura H
- Other Affiliation: WG (Bill) Hefner Medical Center, Salisbury, North Carolina, USA; Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA
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Wilson, Craig M
- Other Affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Kempf, Mirjam C
- Other Affiliation: Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Abstract
- Abstract Background The implementation of highly active antiretroviral therapy (HAART) among HIV-positive patients results in immune reconstitution, slower progression of HIV disease, and a decrease in the occurrence of opportunistic infections. However, the impact of HAART on cervical human papillomavirus (HPV) infection, clearance, and persistence in high-risk adolescents remains controversial. Methods HIV-positive and high-risk HIV-negative female adolescents were enrolled in the Reaching for Excellence in Adolescent Care and Health (REACH) longitudinal cohort study. At each semi-annual clinical visit, cervical lavage samples were tested for 30 HPV types. Type-specific and carcinogenic risk-specific HPV prevalence and incidence were compared in 373 eligible participants: 146 HIV-negative female adolescents with a median follow-up of 721.5 [IQR: 483-1301] days and 227 HIV-positive female adolescents. Of the 227 HIV-positive participants, a fixed set (n = 100) were examined both before and after HAART initiation; 70 were examined only before HAART initiation; and 57 were examined only after HAART initiation, with overall median follow-up of 271 [IQR: 86.5-473] and 427.25 [IQR: 200-871] days respectively for before and after HAART initiation. Results Of the 373 eligible participants, 262 (70%) were infected with at least one type of HPV at baseline, and 78 of the remaining 111 (70%) became infected with at least one type of HPV by the end of the study. Overall, the incidence and prevalence of HPV types 58, 53/66, 68/70, and 31/33/35 were much higher than the established carcinogenic and HPV vaccine types 16 and 18, especially in HIV-positive females both before and after HAART initiation. Baseline prevalence for individual high-risk HPV types ranged, depending on type, from 0.7-10%, 1-17%, and 1-18% in the HIV-negative group, the HIV-positive before HAART initiation group, and the HIV-positive after HAART initiation group, respectively. Likewise, the incidence ranged, depending on HPV type, from 0.64-9.83 cases/100 PY, 3.00-12.80 cases/100 PY, and 1.49-17.05 cases/100 PY in the three groups, respectively. The patterns of each HPV type infection, clearance, and persistence did not differ considerably before or after the introduction of HAART and were clearly independent of CD4+ change within the short post-HAART follow-up period. Conclusions HAART did not immediately affect the incidence of type-specific HPV infections within a short-period follow-up; however, future studies are warranted in larger populations to evaluate HAART's impact over longer periods.
- Date of publication
- October 14, 2010
- DOI
- Identifier
- Resource type
- Article
- Rights statement
- In Copyright
- Rights holder
- Sadeep Shrestha et al.; licensee BioMed Central Ltd.
- License
- Journal title
- BMC Infectious Diseases
- Journal volume
- 10
- Journal issue
- 1
- Page start
- 295
- Language
- English
- Is the article or chapter peer-reviewed?
- Yes
- ISSN
- 1471-2334
- Bibliographic citation
- BMC Infectious Diseases. 2010 Oct 14;10(1):295
- Publisher
- BioMed Central Ltd
- Access right
- Open Access
- Date uploaded
- July 15, 2016
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