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HAART Reduces HPV
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HAART Reduces HPV - Influence of Adherent and Effective Antiretroviral Therapy Use on Human Papillomavirus Infection and Squamous Intraepithelial Lesions in Human Immunodeficiency Virus-Positive Women - (04/13/10)
"The average prevalence of oncogenic HPV infection decreased 36% in adherent women (from 22% before to 14% after HAART initiation) and 12% in nonadherent individuals (from 24% before to 21% after HAART initiation)....adherent women had a highly significant reduction in oncogenic HPV prevalence following their initiation of HAART whereas nonadherent HAART use was not significantly associated with a change in oncogenic HPV prevalence
The Journal of Infectious Diseases March 1 2010;201:681-690
"In summary, we found that effective and adherent HAART use was significantly associated with a reduced burden of HPV infection and SILs among HIV-positive women. These protective effects may help explain why age-specific cervical cancer rates have not increased despite the greater survival of HIV-positive women during the HAART era. However, the overall public health burden of cervical cancer in HIV-positive patients could grow as this population increasingly enters older age groups, which have higher cervical cancer rates......The average prevalence of oncogenic HPV infection decreased 36% in adherent women (from 22% before to 14% after HAART initiation) and 12% in nonadherent individuals (from 24% before to 21% after HAART initiation)....adherent women had a highly significant reduction in oncogenic HPV prevalence following their initiation of HAART (odds ratio [OR] [after vs before], 0.60 [95% confidence interval {CI}, 0.44-0.81]; p=.001), whereas nonadherent HAART use was not significantly associated with a change in oncogenic HPV prevalence (Table 2). A direct comparison of rates in adherent women versus nonadherent women after HAART initiation suggested an about 30% reduction in oncogenic HPV prevalence related to adherence (OR [adherent vs nonadherent], 0.70 [95% CI, 0.48-1.01]; p=.06)......Adherent HAART use was also associated with a reduction in the incident detection rate of oncogenic HPV infection. Specifically, the rate of incident detection decreased 33%......Our major end point was oncogenic HPV-positive SILs (oncHPV+ SILs), lesions that are thought to have the potential to result in tumors. Adherent users had a significant reduction in oncHPV+ SIL prevalence after HAART initiation.....there was a significant relationship between adherent HAART use and the rate of oncHPV+ SIL clearance...which was significantly greater than the oncHPV+ SIL clearance rate observed among nonadherent women.....The average prevalence of oncogenic HPV infection decreased 20% in patients using effective HAART, from 20% before to 14% after HAART initiation, and did not decrease but actually increased slightly in those using ineffective HAART, from 22% before to 24% after HAART initiation."
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