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P3.222 High Risk Human Papillomavirus Viral Load and Persistence Among HIV-Negative and HIV-Positive Men
  1. M K Grabowski1,
  2. R H Gray2,1,
  3. D Serwadda2,3,
  4. G Kigozi4,
  5. P E Gravitt1,5,
  6. F Nalugoda2,
  7. S J Renyolds1,2,6,
  8. M Wawer1,2,
  9. T C Quinn1,6,
  10. A A R Tobian1,7
  1. 1Johns Hopkins, Baltimore, MD, United States
  2. 2Rakai Health Sciences Program, Entebbe, Uganda
  3. 3School of Public Health, Makerere University, Kampala, Uganda
  4. 4Rakai Health Sciences Program, En, Uganda
  5. 5Perdana University Graduate School of Medicine, Serdang, Malaysia
  6. 6Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
  7. 7Rakai Health Sciences Program, Entebbe, Austria


Background High-risk human papillomavirus (HR-HPV) viral load is associated with transmission and persistence in women. It is unknown whether viral load is associated with HR-HPV persistence in HIV-negative or HIV-positive men.

Methods 703 HIV-negative and 233 HIV-positive heterosexual men participated in a male circumcision trial in Rakai, Uganda. Penile swabs were tested at enrollment and 6, 12 and 24 months for HR-HPV using the Roche HPV Linear Array, which provides a semi-quantitative measure of HPV shedding by hybridization band intensity (graded:1–4). Prevalence risk ratios (PRR) were used to estimate the association between HR-HPV viral load and persistent detection of type-specific HR-HPV infection.

Results At least one HR-HPV was identified in 264 HIV-negative men (37.6%, 403 genotypes total) and 164 HIV-positive men (70.4%, 399 genotypes total) at enrollment. Among HIV-negative men, younger and unmarried men were more likely to have higher viral loads. HR-HPV genotypes with high viral load (grade:3–4) at enrollment were more likely to persist than HR-HPV genotypes with low viral load (grade:1–2) among HIV-negative (month 6: adjPRR = 1.80, 95% CI: 1.31–2.47; month 12: adjPRR = 2.04, 95% CI: 1.39–3.01), and HIV-positive men (month 6: adjPRR = 1.33, 95% CI: 1.06–1.67; month 12: adjPRR = 1.70, 95% CI: 1.16–2.50). Long-term persistence of HR-HPV was more frequent among HIV-positive men compared to HIV-negative men (month 24: adjPRR = 2.24, 95% CI: 1.46–3.45), and HR-HPV infections with low viral loads were detected more frequently among HIV-positive men at all follow-up visits (6 months: PRR = 1.81, 95% CI: 1.17–2.97; 12 months: PRR = 1.43, 95% CI: 0.8–2.4; 24 months: PRR = 2.9, 95% CI: 1.53–5.53)

Conclusions HR-HPV genotypes with high viral load are more likely to persist among HIV-negative and HIV-positive men, though persistence was more common among HIV-positive men. The results may explain the association between high HR-HPV viral load and transmission to women and increased levels of HR-HPV persistence in HIV-positive men.

  • HIV
  • HPV
  • viral persistence

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