HUMAN PAPILLOMAVIRUS INFECTION IN HUMAN IMMUNODEFICIENCY VIRUS-SEROPOSITIVE WOMEN

Objective: To compare the prevalence of human papillomavirus (HPV) inf ections in women who are seropositive and seronegative for human immun odeficiency virus (HIV), and to determine if associations between HPV and cervical disease are altered in HIV-seropositive women. Methods: I n this cross-sectional study, 344 HIV-seropositive and 325 HIV-seroneg ative women underwent colposcopy and HPV DNA testing. Results: Human i mmunodeficieney virus-seropositive women were more likely than HlV-ser onegative women to have HPV DNA of any type detected (60 versus 36%, P < .001). Infections with HPV type 16 (27 versus 17%, P <.05), type 18 (24 versus 9%, P <.05), and more than one type of HPV (51 versus 26%, P <.05) were also more common in HIV-positive women. Although both la tent HPV infection and HPV infections associated with cervical intraep ithelial neoplasia (CIN) were more prevalent in the HIV-seropositive g roup, the ratio between these two types of infections was altered mark edly in the HIV-seropositive women. Human immunodeficiency virus-serop ositive women who were HPV-infected were significantly more likely to have CIN than were HPV-infected HIV-seronegative women, an increase ob served at all levels of immunosuppression. Analysis of specific HPV ty pes associated with latent HPV infection and CIN indicated that HIV se ropositivity only minimally alters the known associations between spec ific types of HPV and cervical disease. Conclusion: Human papillomavir us infections are more common among HIV-seropositive women at all leve ls of immunosuppression. However; relationships between HIV and HPV ar e complex and cannot be explained completely by an increased susceptib ility to new HPV infections in the immunosuppressed patient