Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis

Catherine F. Houlihan, Natasha L. Larke, Deborah Watson-Jones, Karen K. Smith-Mccune, Stephen Shiboski, Patti E. Gravitt, Jennifer S. Smith, Louise Kuhn, Chunhui Wang, Richard Hayes

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Human papillomavirus (HPV), one of the commonest sexually transmitted infections, may be a cofactor in HIV acquisition. We systematically reviewed the evidence for an association of HPV infection with HIV acquisition in women, heterosexual men and men who have sex with men (MSM). DESIGN: Systematic review and meta-analysis. METHODS: Studies meeting inclusion criteria in Pubmed, Embase and conference abstracts up to 29 July 2011 were identified. Random effects meta-analyses were performed to calculate summary hazard ratios (HR). Publication bias and statistical heterogeneity were evaluated and population attributable fractions (PAFs) calculated. RESULTS: Eight articles were included, with previously unpublished data from five authors. Seven studies found an association between prevalent HPV and HIV acquisition. Risk of HIV acquisition in women doubled with prevalent HPV infection with any genotype [HR=2.06 (95% CI=1.44-2.94), I=0%], although adjustment for confounders was often inadequate. The effect was similar for high-risk [HR=1.99 (95% CI=1.54-2.56), I=8.4%] and low-risk [HR=2.01 (95% CI=1.27-3.20), I=0%] HPV genotypes with weak evidence of publication bias (P=0.06). Two studies in men were identified: both showed an association between HPV infection and HIV acquisition. Unpublished data from one of two studies in women indicated an association between genotypes targeted by HPV vaccines and HIV acquisition. PAFs for HIV attributable to infection with any HPV genotype ranged between 21 and 37%. CONCLUSION: If further studies validate the association between HPV infection and HIV acquisition, HPV vaccines may reduce HIV incidence in high HPV prevalence populations, in addition to preventing cervical cancer. HIV surveillance studies during implementation of HPV vaccine programmes are warranted.

Original languageEnglish (US)
Pages (from-to)2211-2222
Number of pages12
JournalAIDS
Volume26
Issue number17
DOIs
StatePublished - Nov 13 2012

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Papillomavirus Infections
Meta-Analysis
HIV
Papillomavirus Vaccines
Genotype
Publication Bias
Odds Ratio
Population
Heterosexuality
Sexually Transmitted Diseases
PubMed
Uterine Cervical Neoplasms

Keywords

  • HIV
  • human papillomavirus
  • meta-analysis
  • papillomavirus infections
  • risk factors

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Houlihan, C. F., Larke, N. L., Watson-Jones, D., Smith-Mccune, K. K., Shiboski, S., Gravitt, P. E., ... Hayes, R. (2012). Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. AIDS, 26(17), 2211-2222. https://doi.org/10.1097/QAD.0b013e328358d908

Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. / Houlihan, Catherine F.; Larke, Natasha L.; Watson-Jones, Deborah; Smith-Mccune, Karen K.; Shiboski, Stephen; Gravitt, Patti E.; Smith, Jennifer S.; Kuhn, Louise; Wang, Chunhui; Hayes, Richard.

In: AIDS, Vol. 26, No. 17, 13.11.2012, p. 2211-2222.

Research output: Contribution to journalArticle

Houlihan, CF, Larke, NL, Watson-Jones, D, Smith-Mccune, KK, Shiboski, S, Gravitt, PE, Smith, JS, Kuhn, L, Wang, C & Hayes, R 2012, 'Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis', AIDS, vol. 26, no. 17, pp. 2211-2222. https://doi.org/10.1097/QAD.0b013e328358d908
Houlihan CF, Larke NL, Watson-Jones D, Smith-Mccune KK, Shiboski S, Gravitt PE et al. Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. AIDS. 2012 Nov 13;26(17):2211-2222. https://doi.org/10.1097/QAD.0b013e328358d908
Houlihan, Catherine F. ; Larke, Natasha L. ; Watson-Jones, Deborah ; Smith-Mccune, Karen K. ; Shiboski, Stephen ; Gravitt, Patti E. ; Smith, Jennifer S. ; Kuhn, Louise ; Wang, Chunhui ; Hayes, Richard. / Human papillomavirus infection and increased risk of HIV acquisition. A systematic review and meta-analysis. In: AIDS. 2012 ; Vol. 26, No. 17. pp. 2211-2222.
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abstract = "OBJECTIVES: Human papillomavirus (HPV), one of the commonest sexually transmitted infections, may be a cofactor in HIV acquisition. We systematically reviewed the evidence for an association of HPV infection with HIV acquisition in women, heterosexual men and men who have sex with men (MSM). DESIGN: Systematic review and meta-analysis. METHODS: Studies meeting inclusion criteria in Pubmed, Embase and conference abstracts up to 29 July 2011 were identified. Random effects meta-analyses were performed to calculate summary hazard ratios (HR). Publication bias and statistical heterogeneity were evaluated and population attributable fractions (PAFs) calculated. RESULTS: Eight articles were included, with previously unpublished data from five authors. Seven studies found an association between prevalent HPV and HIV acquisition. Risk of HIV acquisition in women doubled with prevalent HPV infection with any genotype [HR=2.06 (95{\%} CI=1.44-2.94), I=0{\%}], although adjustment for confounders was often inadequate. The effect was similar for high-risk [HR=1.99 (95{\%} CI=1.54-2.56), I=8.4{\%}] and low-risk [HR=2.01 (95{\%} CI=1.27-3.20), I=0{\%}] HPV genotypes with weak evidence of publication bias (P=0.06). Two studies in men were identified: both showed an association between HPV infection and HIV acquisition. Unpublished data from one of two studies in women indicated an association between genotypes targeted by HPV vaccines and HIV acquisition. PAFs for HIV attributable to infection with any HPV genotype ranged between 21 and 37{\%}. CONCLUSION: If further studies validate the association between HPV infection and HIV acquisition, HPV vaccines may reduce HIV incidence in high HPV prevalence populations, in addition to preventing cervical cancer. HIV surveillance studies during implementation of HPV vaccine programmes are warranted.",
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