Prevalence, incidence, and type-specific persistence of human papillomavirus in human immunodeficiency virus (HIV)-positive and HIV-negative women

Human immunodeficiency virus (HIV) infection and related immunosuppression are associated with excess risk for cervical neoplasia and human papillomav irus (HPV) persistence. Type-specific HPV infection was assessed at 6-month intervals for HIV-positive and HIV-negative women (median follow-up, 2.5 a nd 2.9 years, respectively). The type-specific incidence of HPV infection w as determined, and risk factors for HPV persistence were investigated by st atistical methods that accounted for repeated measurements. HIV-positive wo men were 1.8, 2.1, and 2.7 times more likely to have high-, intermediate-, and low-risk HPV infections, respectively, compared with HIV-negative women . In multivariate analysis, high viral signal, but not viral risk category, was independently associated with persistence among HIV-positive subjects (odds ratio [OR], 2.5; 95% confidence interval [CI], 2.1-2.9). Furthermore, persistence was 1.9 (95% CI, 1.5-2.3) times greater if the subject had a C D4 cell count <200 cells/<mu>L (vs. >500 cells/muL). Thus, HIV infection an d immunosuppression play an important role in modulating the natural histor y of HPV infection.