PT  - JOURNAL ARTICLE
AU  - Mary K Grabowski
AU  - Ronald H Gray
AU  - David Serwadda
AU  - Godfrey Kigozi
AU  - Patti E Gravitt
AU  - Fred Nalugoda
AU  - Steven J Reynolds
AU  - Maria J Wawer
AU  - Stephen Watya
AU  - Thomas C Quinn
AU  - Aaron A R Tobian
TI  - High-risk human papillomavirus viral load and persistence among heterosexual HIV-negative and HIV-positive men
AID  - 10.1136/sextrans-2013-051230
DP  - 2014 Jun 01
TA  - Sexually Transmitted Infections
PG  - 337--343
VI  - 90
IP  - 4
4099  - http://sti.bmj.com/content/90/4/337.short
4100  - http://sti.bmj.com/content/90/4/337.full
SO  - Sex Transm Infect2014 Jun 01; 90
AB  - Objectives High-risk human papillomavirus (HR-HPV) viral load is associated with HR-HPV transmission and HR-HPV persistence in women. It is unknown whether HR-HPV viral load is associated with persistence in HIV-negative or HIV-positive men. Methods HR-HPV viral load and persistence were evaluated among 703 HIV-negative and 233 HIV-positive heterosexual men who participated in a male circumcision trial in Rakai, Uganda. Penile swabs were tested at baseline and 6, 12 and 24 months for HR-HPV using the Roche HPV Linear Array, which provides a semiquantitative measure of HPV shedding by hybridisation band intensity (graded: 1–4). Prevalence risk ratios (PRR) were used to estimate the association between HR-HPV viral load and persistent detection of HR-HPV. Results HR-HPV genotypes with high viral load (grade:3–4) at baseline were more likely to persist than HR-HPV genotypes with low viral load (grade: 1–2) among HIV-negative men (month 6: adjPRR=1.83, 95% CI 1.32 to 2.52; month 12: adjPRR=2.01, 95% CI 1.42 to 3.11), and HIV-positive men (month 6: adjPRR=1.33, 95% CI 1.06 to 1.67; month 12: adjPRR=1.73, 95% CI 1.18 to 2.54). Long-term persistence of HR-HPV was more frequent among HIV-positive men compared with HIV-negative men (month 24: adjPRR=2.27, 95% CI 1.47 to 3.51). Persistence of newly detected HR-HPV at the 6-month and 12-month visits with high viral load were also more likely to persist to 24 months than HR-HPV with low viral load among HIV-negative men (adjPRR=1.67, 95% CI 0.88 to 3.16). 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 overall. The results may explain the association between high HR-HPV viral load and HR-HPV transmission.