Background The HPV seropositivity following natural infection can provide data on cumulative exposure to HPV. Studies evaluating seropositivity prospectively among men living with HIV (MLHIV) are few. We aimed to determine HPV type specific seroprevalence and seroconversion among MLHIV following natural HPV infection.

Methods We enrolled 304 sexually-active MLHIV ≥18 years from Johannesburg. We collected socio-behavioral data, blood (CD4+ counts, HIV-1 plasma viral load [PVL] and serology), and genital swabs (HPV genotyping with Roche Linear Array and HPV 16/18 Viral Load [VL]) at enrolment and 6-monthly follow-up visits for up to 18 months. At enrolment and 18 months later, type-specific serum antibodies to 15 HPV types (HPV6/11/16/18/31/33/35/39/45/52/56/58/59/68/73) were measured using HPV pseudovirions. Logistic regression evaluated factors associated with HPV seroconversion.

Results At enrolment, median age was 38 (IQR: 22–59) years, 25% reported ≥1 sexual partners in the past 3 months and 5% reported ever having sex with other men. Most participants (65%) were on ART, with median CD4+ count 445 cells/µL (IQR: 328–567). Serology results were available for 99% of the 304 and 257 men who completed enrolment and 18 months visits. Seroprevalence of any HPV type was 66%. Seropositivity for any HPV types of the bivalent (HPV16/18), quadrivalent (HPV6/11/16/18) and nonavalent (HPV6/11/16/1831/33/45/52/58) vaccines were 19%, 37% and 60% respectively. Among 59 men with genital HPV-DNA but seronegative for the same type at enrolment, 12 (22%) had type-specific seroconversion at month 18. Among these men, the risk of type specific seroconversion was higher among men with detectable PVL (aOR=2.78, 95%CI: 1.12–6.77), and HPV 18 VL ≥ 5.3 log10/106cells (aOR=3.32, 95%CI: 1.42–7.74).

Conclusion MLHIV have high HPV seroprevalence rates implying that prevention of HPV infection is required. There is evidence of seroconversion in response to detectable DNA infection at baseline, which was associated with both high HIV and HPV 18 viral loads.

Disclosure No significant relationships.