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Women infected with HIV also have
high rates of infection with high-risk strains of human papillomavirus (HPV)
that cause cervical cancer. Researchers in Brussels, Belgium, have proved that
an undetectable viral load and sustained immune reconstitution in women with
HIV infection reduces risk of persistent cervical infection with strains of
HPV. The researchers conducted a prospective study of 652 women with HIV
infection who had regular Pap tests between 2002 and 2011. They investigated
factors associated with prevalent, incident, and persistent high-risk cervical
HPV infection. The majority of the participants (84 percent) were from
sub-Saharan Africa and their median age at first HPV screening was 38 years.
Median baseline CD4 cell count was 426 cells per cubic millimeter. More than
three-quarters (79 percent) of participants were receiving HIV therapy and 56
percent had an undetectable viral load. The researchers followed up with
participants for a median of 103 months.
Statistical analysis showed that a
low CD4 cell count (above 500 cells per cubic millimeter) and antiretroviral
treatment for two or more years with an undetectable viral load were associated
with a reduced risk of high-risk HPV infection. Fifty-four participants with a
negative baseline screen were later infected with a high-risk HPV strain. Of
the women with HPV, 63 cleared the infection, but it persisted in 77 of them.
Researchers found a significant and independent association with undetectable
viral load for 24 or more months and clearance of the infection. They also
examined factors associated with high-risk cervical HPV infection during the
study.
Findings indicated that older age,
longer period of time with high CD4 cell count, and longer time with viral
suppression were associated with lower risk of carrying high-risk strains. Age
under 30 years was a risk factor for infection during the study; risk decreased
significantly if CD4 cell count went above 500 cells per cubic millimeter for
at least 18 months and viral load was low for four or more months. The authors
believe that further research is needed to determine whether early HIV therapy
can lower the risk of high-risk HPV infection and cervical cancer.
The full report, “Sustained Viral
Suppression and Higher CD4 Cell Count Reduces the Risk of Cervical Persistent
Infection with High Risk Human Papillomavirus in HIV-Positive Women,” was
published online in the Journal of Infectious Diseases (2013;
doi:10.1093/infdis/jit090).
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
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