RISK OF GENITAL HUMAN PAPILLOMAVIRUS INFECTION IN WOMEN WITH HUMAN IMMUNODEFICIENCY VIRUS-INDUCED IMMUNOSUPPRESSION

This study examined the risk factors for genital human papillomavirus (HPV) infection, including HIV-related immunosuppression as well as de mographic and behavioral factors. Subjects were 207 women with known H IV serologic status, the majority of whom were intravenous drug users recruited from a methadone treatment program in the Bronx, New York. A structured questionnaire interview, cervico-vaginal lavage, and CD4 c ell measurements were obtained. HPV genomes in the cervico-vaginal cel ls were detected by Southern-blot hybridization. HPV prevalence was 23 % among HIV seronegatives, 45% among HIV seropositives with CD4 percen t >20 and 61% among HIV seropositives with CD4 percent less than or eq ual to 20. Multivariate analysis identified the following independent risk factors that were significantly associated with HPV positivity: H IV-related immunosuppression, <35 years of age, and never used oral co ntraceptive pills. HIV-related immunosuppression was also associated w ith a stronger Southern-blot signal strength. HIV infection, however, did not increase the susceptibility to HPV infection with the oncogeni c types (16, 18, 31, 33 and 35). Women with HIV infection or immunosup pression had a higher prevalence of HPV infection with the oncogenic t ypes, but they also had an increased prevalence of infection with othe r HPV types as compared to the HIV-seronegative women. The results sug gest that HIV-related immunosuppression increases the risk of genital HPV infection and has an effect on HPV replication. (C) 1994 Wiley-Lis s, Inc.