Association of genital human papillomavirus infection with HIV acquisition: a systematic review and meta-analysis
- 1CESP INSERM-UVSQ UMRS-1018, Villejuif, France
- 2INSERM U1058, Montpellier, France
- 3UFR of Medicine, University Montpellier 1, Montpellier, France
- 4Department of Bacteriology-Virology, CHU Montpellier, Montpellier, France
- 5University of Versailles-Saint-Quentin, Versailles, France
- 6Assistance Publique- Hôpitaux de Paris, Hôpital Ambroise-Paré, Boulogne, France
- 7Institut Universitaire de France, France
- Correspondence to Professor Bertran Auvert, CESP INSERM-UVSQ UMRS-1018, Hôpital Paul Brousse, 16 avenue Paul Vaillant-Couturier, Villejuif 94807, France;
- Received 3 November 2011
- Revised 30 April 2013
- Accepted 7 May 2013
- Published Online First 12 June 2013
Objectives To conduct a systematic review and a meta-analysis of epidemiological studies investigating the association of genital human papillomavirus (HPV) infection and HIV acquisition.
Design Systematic review and meta-analysis.
Data Sources Scientific databases and conference abstracts were systematically searched to identify all relevant studies published up to 31 January 2012. Search terms included ‘HIV’, ‘HPV’, ‘human papillomavirus’ and ‘papillomaviridae’ as keywords or text, in the title or abstract.
Methods To be eligible for inclusion, a study had to be conducted among humans, report data on HIV incidence, and assess genital HPV infection. Summary ORs and 95% CIs were estimated from the extracted data using random-effect meta-analysis. Subgroup analyses were conducted for high-risk (HR) and low-risk (LR) HPV oncogenic risk groups. Between-study heterogeneity and publication bias were assessed.
Results Of 2601 identified abstracts, six observational studies, comprising 6567 participants were retained for the systematic review and the meta-analysis. HIV acquisition was significantly associated with HPV infection (summary OR=1.96; 95% CI 1.55 to 2.49). HIV incident infection was significantly associated with HR-HPV in five of six studies and with LR-HPV in two out of five. The association was significant for HR-HPV (summary OR=1.92; 95% CI 1.49 to 2.46) and borderline for LR-HPV. No between-study heterogeneity was detected. There was a borderline indication of publication bias.
Conclusions Further research is needed to elucidate the biological mechanisms involved, and assess the effect of HPV vaccination on HIV acquisition, using vaccines with broad coverage of HPV genotypes. Such research could have important public health implications for HIV prevention.
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