In the largest study of its kind, a national team led by a UC San Francisco scientist has found strong new evidence that HIV-positive women run a high risk of infection with human papillomavirus (HPV), a major cause of cervical cancer. Women who already harbor the HIV virus are, on average, twice as likely to be infected with HPV than are high-risk HIV-negative women, the researchers found. The odds jump to a ten-fold greater risk of HPV infection among the most immune-suppressed women.
Although HIV status was by far the single-greatest risk factor for infection with HPV, the large size of the study group enabled the researchers to determine many other risk factors that had eluded previous, much smaller studies. Younger women, African American women and those who currently smoke each face more than a 50 percent increased likelihood of HPV infection than women over 40, Caucasians and non-smokers respectively, the researchers found.
The findings appear in the February 3 issue of the Journal of the National Cancer Institute.
The study provides new support for the view that the increased HPV disease among HIV-positive women results from reactivation or persistence of previously acquired HPV rather than recent acquisition of the virus.
The study was conducted before protease inhibitors were in widespread clinical use. However, it is possible that HIV-positive women who gain a new lease on life through protease inhibitors and other potent new treatments may face increased risk that an HPV condition will lead to cervical cancer as they live longer.
"Cervical cancer may take many years to develop," explains Joel Palefsky, MD,
associate professor of laboratory medicine at UCSF and leader of the study.
"With powerful new treatments that allow them to live a longer life with HIV,
women who also have HPV infections unfortunately may face a greater likelihood
than before of developing this cancer if they do not regularly undergo the
currently recommend
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Contact: Wallace Ravven
wravven@itsa.ucsf.edu
415-476-2557
University of California - San Francisco
3-Feb-1999