A LONGITUDINAL-STUDY OF HUMAN-PAPILLOMAVIRUS CARRIAGE IN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED AND HUMAN IMMUNODEFICIENCY VIRUS-UNINFECTED WOMEN

OBJECTIVE: We sought to determine the relationship of human immunodefi ciency virus serostatus to carriage of oncogenic human papillomavirus. MATERIAL AND METHODS: A total of 268 human immunodeficiency virus-inf ected and 265 human immunodeficiency virus-uninfected women were seen every 6 months, at which time they had laboratory tests performed incl uding a CD4 count. Human papillomavirus deoxyribonucleic acid was anal yzed by polymerase chain reaction. Statistical methods included Kaplan -Meier and Cox's proportional hazard models. RESULTS: The prevalence a t baseline of any human papillomavirus type was 73% and 43% among huma n immunodeficiency virus-seropositive and seronegative women, respecti vely (p < 0.0001)and of oncogenic types was 32.5% and 17.0%(p < 0.001) . The prevalence of oncogenic human papillomavirus was higher in women with CD4 counts <200 mm(3) (p < 0.001). The rate of detection of new oncogenic human papillomavirus per 100 patient years of follow-up in h uman immunodeficiency virus-seropositive women was almost three times higher than among human immunodeficiency virus-seronegative women (p < 0.01). The rate of loss oi an oncogenic human papillomavirus was high er in the human immunodeficiency virus-seronegative women but the diff erence was not significant. The relative risk of a human immunodeficie ncy virus-infected woman who did not initially have a specific type of oncogenic human papillomavirus having one detected during follow-up w as 6.6 times greater than among human immunodeficiency virus-negative women (p < 0.001). CONCLUSIONS: Human immunodeficiency virus-seroposit ive women are more likely to have newly detectable oncogenic types of human papillomavirus at follow-up and to show persistent carriage of o ncogenic types of human papillomavirus types. Among human immunodefici ency virus-infected women, those with higher CD4 counts were more like ly to have a detected oncogenic human papillomavirus during follow-up.