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Human papillomavirus antibody response following HAART initiation among MSM.

Human papillomavirus antibody response following HAART initiation among MSM.
Author Information (click to view)

Combes JD, Clifford GM, Egger M, Cavassini M, Hirsch HH, Hauser C, Calmy A, Schmid P, Bernasconi E, Günthard HF, Franceschi S, Waterboer T, Scherrer AU, ,


Combes JD, Clifford GM, Egger M, Cavassini M, Hirsch HH, Hauser C, Calmy A, Schmid P, Bernasconi E, Günthard HF, Franceschi S, Waterboer T, Scherrer AU, , (click to view)

Combes JD, Clifford GM, Egger M, Cavassini M, Hirsch HH, Hauser C, Calmy A, Schmid P, Bernasconi E, Günthard HF, Franceschi S, Waterboer T, Scherrer AU, ,

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AIDS (London, England) 31(4) 561-569 doi 10.1097/QAD.0000000000001354

Abstract
OBJECTIVE
To describe effects of HAART on high-risk human papillomavirus (HPV) antibody response in HIV-positive MSM and the meaning of this response for subsequent HPV-related cancer risk.

DESIGN
Prospective seroepidemiological study of 281 HIV-positive MSM initiating HAART between 1995 and 2004 in the Swiss HIV Cohort Study.

METHODS
For each individual, two serum samples, one at HAART initiation (pre-HAART) and another 24 months later (post-HAART), were tested for L1 antibodies to HPV6, 11, 16, 18, 31, 33, 35, 45, 52 and 58, as well as HPV16-E6 antibodies, using a multiplex serology assay. Identification of HPV-related cancer included data linkage with Swiss cancer registries.

RESULTS
Pre-HAART, 45.2% were seropositive for any high-risk HPV-L1 and 32.4% for HPV16-L1. Sexual intercourse during the last 6 months was the only evaluated factor associated with L1 seropositivity pre-HAART. Seropositivity increased post-HAART to 60.5% for any high-risk HPV-L1 [prevalence ratio versus pre-HAART = 1.34, 95% confidence interval (CI) 1.14-1.57] and 48.0% for HPV16-L1 (prevalence ratio versus pre-HAART = 1.48, 95% CI 1.20-1.83), and seroconversion was significantly associated with both lower CD4 cell count and CD4/CD8 ratio (P < 0.01). Only one individual was HPV16-E6-seropositive pre-HAART, but two more seroconverted post-HAART. Anal cancer incidence among the three HPV16-E6-positives post-HAART was significantly increased compared with HPV16-E6-negatives (incidence rate ratio = 63.1, 95% CI 1.1-1211). CONCLUSION
HAART-related immune reconstitution increases HPV-specific antibody responses, which may discriminate future anal cancer risk in this high-risk population.

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