The purpose of this study is to define and characterize HR-HPV infections and related illnesses in HIV-infected women. Co-testing was used to screen and follow-up on HPV in 805 HIV-infected women recruited in the VALHIDATE Study. Data on social, behavioral, and health issues were gathered. Positive HPV-DNA samples were typed using a commercial kit or RFLP analysis. Participants whose cytological findings were abnormal were referred for colposcopy. 565 HIV-infected women were studied; 40.9 percent had more than five-lifetime sexual partners, 77.2 percent contracted HIV through sexual contact, 93 percent were on antiretroviral therapy, and 77.3 percent had undetectable HIV-RNA. The women had 1254 follow-ups for a total of 1430.6 PersonYear-Follow-Up. Incident HPV infections were acquired by 37.4 percent of baseline HPV-negative women, with HR-HPVs accounting for 69.6 percent of the infections. The most frequent HPV type found was HPV-53. Colposcopy detected CIN2, CIN1, and VIN3 in 18.2 percent of the women who had an incident or progressive cytological abnormalities. The avoidable percentage of incident infections for the 2v-4v-9v-HPV vaccinations was 11.3 percent, 16.7 percent, and 35.2 percent, respectively. The total burden of incident lesions attributed to vaccination types was 9.1% for 2v-vaccine, 14.5 percent for 4v-vaccine, and 30.9 percent for 9v-vaccine.
A cohort of HIV-infected women receiving effective antiretroviral therapy had a high HPV incidence rate and a significant prevalence of multiple HR-HPV infections. Primary preventive methods based on the new 9v-HPV vaccination may aid in the prevention of incident infections and disease progression in this population of women.
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