Human immunodeficiency virus type 1-related nucleic acids and papillomavirus DNA in cervicovaginal secretions of immunodeficiency virus-infected women

Objective: To evaluate simultaneous human immunodeficiency virus (HIV)-rela ted nucleic acids and human papillomavirus (HPV)-DNA in cervicovaginal secr etions of HIV-seropositive women. Methods: We collected 47 paired blood and cervicovaginal lavage samples fro m 124 know HIV-1-seropositive women. Proviral HIV-1 DNA, cell-associated, a nd cell-free HIV-1 RNA in cervicovaginal secretions were quantitatively eva luated by competitive polymerase chain reaction (PCR) and reverse transcrip tion PCR. Polymerase chan reaction and subsequent restriction fragment leng th polymorphism analysis of PCR products were used to detect HPV types 6, 1 1, 16, 18, 31, 33, 35, and 56. Results: Proviral HIV-1 DNA, cell-associated, and cell-free HIV-1 RNA were detected in 52.4% (65 of 124), 38.7% (48 of 124), and 33.9% (42 of 124) of lavage samples, respectively. Human papillomavirus-DNA in cervicovaginal se cretions was detected in 64% (79 of 124) of participants. The rate of detec tion of HPV types of intermediate to high oncogenic risk was higher in HIV- positive women who tested positive for cell-associated (odds ratio [OR] 3.5 7, 95% confidence interval [CI] 1.17, 11.12) or cell-free (OR 4.63, 95%, CI 1.42, 15.51) HIV-1 RNA in cervicovaginal secretions than their counterpart s who tested negative. Logistic regression analysis showed that the associa tion between HPV infection and the detection of HIV-1 RNA in cervicovaginal secretions persisted after adjustment for potential confounders such as CD 4+ cell counts, HIV-1 RNA in plasma, use of antiretroviral drugs, vaginal i nfection, and regular condom use. In univariable and multivariable analysis , HPV-DNA detection was associated in cervicovaginal secretions (chi (2) fo r trend 10.35, and 9.84, P = .001 and .002, respectively). Conclusions: The rate of HPV detection in the genital tract of HIV-1-seropo sitive women is associated with the amount of cell-associated and cell-free HIV-1 RNA present in cervicovaginal secretion. The association does not ap pear to be attributable entirely to the effect of HIV-related immunodepress ion. (Obstet Gynecol 2001;97:999-1004. (C) 2001 by The American College of Obstetricians and Gynecologists.).