Ahdieh L, Klein R S, Burk R, Cu-Uvin S, Schuman P, Duerr A, Safaeian M, Astemborski J, Daniel R, Shah K
Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
J Infect Dis. 2001 Sep 15;184(6):682-90. doi: 10.1086/323081. Epub 2001 Aug 24.
Human immunodeficiency virus (HIV) infection and related immunosuppression are associated with excess risk for cervical neoplasia and human papillomavirus (HPV) persistence. Type-specific HPV infection was assessed at 6-month intervals for HIV-positive and HIV-negative women (median follow-up, 2.5 and 2.9 years, respectively). The type-specific incidence of HPV infection was determined, and risk factors for HPV persistence were investigated by statistical methods that accounted for repeated measurements. HIV-positive women 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 CD4 cell count <200 cells/microL (vs. >500 cells/microL). Thus, HIV infection and immunosuppression play an important role in modulating the natural history of HPV infection.
人类免疫缺陷病毒（HIV）感染及相关免疫抑制与宫颈癌变和人乳头瘤病毒（HPV）持续感染风险增加有关。对HIV阳性和HIV阴性女性每隔6个月评估一次型特异性HPV感染情况（中位随访时间分别为2.5年和2.9年）。确定了HPV感染的型特异性发病率，并采用考虑重复测量的统计方法研究了HPV持续感染的危险因素。与HIV阴性女性相比，HIV阳性女性发生高危、中危和低危HPV感染的可能性分别高出1.8倍、2.1倍和2.7倍。在多变量分析中，高病毒信号而非病毒风险类别与HIV阳性受试者的持续感染独立相关（比值比[OR]为2.5；95%置信区间[CI]为2.1 - 2.9）。此外，如果受试者的CD4细胞计数<200个/微升（与>500个/微升相比），持续感染的可能性会高出1.9倍（95%CI为1.5 - 2.3）。因此，HIV感染和免疫抑制在调节HPV感染的自然病程中起重要作用。
