Incidence, persistence, clearance and correlates of genital human papillomavirus infection and anogenital warts in a cohort of men living with HIV South Africa

Sexually Transmitted Diseases
Admire ChikandiwaSinead Delany-Moretlwe

Abstract

To estimate the incidence; persistence and correlates of HPV infection and anogenital warts (AGW) among men living with HIV (MLHIV). Overall, 304 MLHIV ≥18 years were enrolled and attended follow-up visits at 6, 12 and 18 months. Clinicians examined for AGW, collected blood, and penile swabs for HPV testing (Roche Linear Array) at each visit. Time to AGW incidence or clearance was estimated by Kaplan-Meier method. Factors associated with persistent HPV infection and AGW clearance were evaluated with generalized estimating equations and Cox regression respectively. Mean age of participants was 38 (Standard Deviation, 8) years; 25% reported >1 sexual partner in the past 3 months. Most (65%) participants were on antiretroviral treatment (ART) with a median CD4+ count of 445 cells/μL (IQR, 328-567). Prevalence of HPV infection and AGW at enrolment were 79% (224/283) and 12% (36/304) respectively. 259 men were followed for a median (IQR) 1.4 years (0.5-1.7). Incidence of any-genital HPV infection was 2.9 (95% CI: 1.5-5.5) per 100 person-years. Persistence of any-genital HPV infection was 35% (68/192) and was higher among MLHIV with low CD4+ count (adjusted Odds Ratio=3.54; 95%CI: 2.07-6.05). Incidence of AGW was 1.4 per 100 person-y...Continue Reading

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