Trends and Determinants of Human Papillomavirus Concordance Among Human Immunodeficiency Virus–Positive and –Negative Heterosexual Couples in Rakai, Uganda. (23rd December 2016)

• Record Type: Journal Article
• Authors: Grabowski, Mary K.; Gravitt, Patti E.; Gray, Ronald H.; Serwadda, David; Redd, Andrew D.; Kigozi, Godfrey; Kong, Xiangrong; Nalugoda, Fred; Wawer, Maria J.; Quinn, Thomas C.; Tobian, Aaron A. R.
• Is Part Of: Journal of infectious diseases. Volume 215:Number 5(2017:Mar. 01)
• Page Start: 772
• Page End: 780
• Publication Date: 2016-12-23
• Subjects: Human papillomavirus (HPV) -- concordance -- male circumcision -- HIV -- Uganda -- sexually transmitted infections.; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiw631
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: Limited data are available on human papillomavirus (HPV) infection among human immunodeficiency virus (HIV)–negative or HIV-positive couples followed longitudinally. Methods: Genital HPV was assessed in 725 concordant HIV-negative couples and 209 HIV-positive couples enrolled in a male circumcision trial in Rakai, Uganda, using the Roche Linear Array assay, which detects 37 HPV genotypes. Human papillomavirus prevalence and determinants of genotype-specific concordance were assessed at annual visits. Cumulative detection of HPV genotypes over 2 years was also assessed. Results: At enrollment, HPV infection was detected in 54% of HIV-negative women, 56% of HIV-negative men, and 93% of HIV-positive men and women. For HIV-negative couples, genotypic concordance was 30% at baseline (n = 219/725) and declined significantly with age (adjusted prevelance risk ratio [adjPRR] = 0.53; 95% confidence interval [CI] = 0.28–0.93 comparing women aged > 40 years to those aged 15–19 years) and male circumcision (adjPRR = 0.60; 95% CI = 0.47–0.77) and increased among couples with recent intercourse (adjPRR = 1.26; 95% CI = 1.04–1.53). These associations were not seen in HIV-positive couples. Among couples with HPV results at all visits, ≥ 1 of the same genotypes were detected in both partners in 60% of HIV-negative couples and 96% of HIV-positive couples over 2 years. Conclusion: Human papillomavirus genotype-specific concordance is more common in HIV-positive couples, and irrespective of HIV status, the majority of couples exhibit HPV concordance over 2 years.