Characteristics of identified studies investigating the association between genital HPV infection and HIV acquisition
| Study type; first author; year; | Study setting | Study population | HPV sampling | Length of follow-up (months) | Number of incident HIV cases | Type of ratio estimate | HPV prevalence | HIV incidence ratio estimates (crude) (95% CI) | HIV incidence ratio estimates (adjusted) (95% CI) | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| nested cohort studies | Gender and population type | Age (years) | n | ||||||||
| Chin-Hong et al 2009 | USA | Men Men who have sex with men | 16 and older | 1409 | Anal swabs at baseline | 48 | 51 | HR | HPV: 56.8% | 3.6 (1.5 to 8.4)* | 3.5(1.2 to 10.6)* |
| HR-HPV: 26.4% | NR | NR | |||||||||
| LR-HPV: 25.6% | NR | NR | |||||||||
| Smith-McCune et al 2010 | Zimbabwe | Women general population | 18–49 | 1987 | Cervical swabs at baseline and 12-month visit; quarterly vaginal swabs | 21 | 88 | HR | Baseline HPV: 24.5% | NR | 1.6 (1.0 to 2.7) |
| Baseline HR-HPV: 16.1% | NR | 2.0 (1.2 to 3.2) | |||||||||
| Baseline LR-HPV: 10.8% | NR | 1.5 (0.92 to 2.4) | |||||||||
| Smith et al 2010 | Kenya | Men general population | 18–24 | 2168 | Exfoliated penile cells from glans/coronal sulcus† at baseline | 42 | 63 | HR | HPV: 50.2% | NR | 1.8 (1.1 to 2.9) |
| At least one HR-HPV‡: 34.8% | NR | 1.5 (0.9 to 2.6) | |||||||||
| Only LR-HPV‡: 15.5% | NR | 1.9 (0.9 to 3.6) | |||||||||
| Veldhuijzen et al 2010 | Rwanda | Women high risk (96% sex workers) | median 25 | 324 | Cervical samples at month 6 | 24 | 10 | OR | HPV: 47.8% | NR | NR |
| HR-HPV: 33.3% | 4.9 (1.2 to 19.7) | NR | |||||||||
| LR-HPV: 34.3% | NR | NR | |||||||||
| Auvert et al 2011 | South Africa | Women High-risk (all sex workers) | median 24 | 88 | first available cervico-vaginal rinses of 3 obtained during follow-up, before seroconversion | 30 (median) | 25 | HR | HPV: | NR | NR |
| HR-HPV: 70.5% | 1.5 (1.1 to 2.1)§ | 1.7 (1.0 to 2.7)§ | |||||||||
| LR-HPV: 60.2% | 1.1 (0.77 to 1.5)§ | 0.95 (0.68 to 1.3)§ | |||||||||
| Case-control Study | |||||||||||
| Averbach et al 2010 | Zimbabwe | Women general population | 18–35 | 145 cases and 446 controls | Cervical swabs at t−1 (t0=time of HIV detection) | t0−t−1=80.5 days 21.9 | 145 | OR | HPV : 49.1% | 2.7 (1.7 to 4.1) | 2.4 (1.5 to 4.0) |
| Any HR-HPV: 37.1% | 2.7 (1.7 to 4.3) | 2.3 (1.4 to 3.9) | |||||||||
| Only LR-HPV: 12.0% | 2.5 (1.3 to 4.6) | 2.8 (1.3 to 5.9) | |||||||||
Bold indicates statistically significant estimates.
*Infection with two or more HPV genotypes.
†Sampling penile shaft for HR-HPV and LR-HPV.
‡HPV infections with multiple HPV types were considered high risk if one or more HR-HPV type was detected. All the others were considered LR-HPV infections.
§Infection with one HPV genotype versus no HPV.
HPV, human papillomavirus; HR-HPV, high-risk HPV; IRR, incidence rate ratio; LR-HPV, low-risk HPV; NR, not reported; RCT, randomised control trial.