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1 Johns Hopkins University School of Medicine and 2 School of Public Health, Baltimore, Maryland; 3 Center for Statistical Sciences, Department of Community Health and 4 The Miriam Hospital, Brown University, Providence, Rhode Island; 5 Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York; and 6 Harper Hospital, Detroit, Michigan
Requests for reprints: Raphael P. Viscidi, Johns Hopkins Hospital, Blalock Room 1105, 600 North Wolfe Street, Baltimore, MD 21287. Phone: 410-614-1494; Fax: 410-955-3723. E-mail: rviscid1{at}jhem.jhmi.edu
The association between seropositivity to virus-like particles (VLP) of human papillomavirus (HPV) types 16, 18, 31, 35, or 45 and subsequent cervical HPV infection was examined in 829 women with HIV and 413 risk-matched HIV-negative women. We found no statistically significant differences between HPV-seropositive and HPV-seronegative women in the risk of a new infection with the homologous HPV type, with the exception of a reduced risk of HPV 45 infections 4.5 years beyond the baseline serology measurement in HIV-positive women [hazard ratio, 0.21; 95% confidence interval (CI), 0.05-0.89]. Among HIV-negative women, HPV seropositivity was not associated with a statistically significant reduced risk of infections with related viruses in the HPV 16, HPV 18, or "other" HPV groups. Among HIV-positive women, HPV seropositivity was associated with a slightly increased risk of infection with group-related viruses, but the differences were only statistically significant for infection with HPV 16 group viruses (hazard ratio, 1.6; 95% CI, 1.1-2.3) in HPV 18-seropositive women and for infections with "other" HPV group viruses in HPV 31-seropositive women (hazard ratio, 1.45; 95% CI, 1.0-2.0). The lack of a protective immune effect from natural infection is most likely due to the low level of antibody elicited by natural HPV infection and/or the potential for reactivation of HPV, especially in HIV-positive women.
Key Words: HPV • HIV • VLP Antibodies • Protective Immunity • Human tumor viruses
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