The study, reported by Howard Minkoff and coworkers at SUNY Downstate and other centers, involved 1,797 HIV-infected and 496 uninfected women whose smoking and HPV status was monitored at six-month intervals from 1994 to 1998. Smoking status was determined in interviews, HPV status by cervicovaginal lavage for HPV DNA testing. Other factors studied included age, T cell subset concentrations, anti-HIV drug regimen use, HIV RNA levels, oral contraceptive use, and sexual activity.
The investigators found that, regardless of smoking status, HIV-infected women were 3.9 times more likely than women not infected with HIV to have HPV infection at the outset of the study. When smoking was factored into the analysis, heightened HPV risk at the outset was seen only in HIV-infected women. HIV-infected women were also 3.13 times more likely to acquire HPV infection during the study, and smoking significantly increased HPV risk in such women. Finally, both HIV-infected subjects and those who smoked were significantly more likely than their uninfected or nonsmoking counterparts to acquire persistent HPV infection (defined as occurring during the study and present at two consecutive visits).
Noting that persistent HPV infections have been shown to increase the risk of cervical cancer, Minkoff and coworkers commented that smoking and HIV infection may each alter the natural history of HPV infection to heighten tumor risk, an
Contact: Jeff Minerd
Infectious Diseases Society of America