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Human Papillomavirus (HPV) Detection Among Human Immunodeficiency Virus–Infected Pregnant Thai Women: Implications for Future HPV Immunization

Bollen, Liesbeth J. M. MD, PhD*; Chuachoowong, Rutt MD, DrPH*; Kilmarx, Peter H. MD*†; Mock, Philip A. MAppStats*; Culnane, Mary MS, CRNP*†; Skunodom, Natapakwa MA*; Chaowanachan, Thanyanan MSc*; Jetswang, Bongkoch RN*; Neeyapun, Kanchana RN*; Asavapiriyanont, Suvanna MD; Roongpisuthipong, Anuvat MD§; Wright, Thomas C. MD; Tappero, Jordan W. MD, MPH*†

Sexually Transmitted Diseases: April 2006 - Volume 33 - Issue 4 - p 259-264
doi: 10.1097/01.olq.0000187208.94655.34

Background: Human immunodeficiency virus (HIV)–infected women are at increased risk for developing cervical cancer and for infection with human papillomavirus (HPV). Prophylactic vaccines targeting HPV types 16 and 18 are being evaluated for efficacy among young women.

Goal: The goal was to assess the prevalence of HPV among HIV-infected pregnant women in Bangkok and to evaluate the need for prophylactic HPV vaccines studies in this population.

Study Design: The study population consisted of 256 HIV-infected pregnant women who participated in a mother-to-child HIV transmission trial. Stored cervicovaginal lavage samples were tested for the presence of HPV DNA by polymerase chain reaction with PGMY09/11 primers and reverse line-blot hybridization for determination of anogenital HPV types.

Results: HPV prevalence was 35.5% (91/256); high-risk HPV prevalence was 23.4% (60/256). HPV type 16 or 18 was present in 8.2% (21/256). Almost half of all infections were multiple. Furthermore, overall HPV detection was associated with abnormal cervical cytology (P <0.001) and higher HIV-plasma viral load (P = 0.007).

Conclusions: Only one-quarter of HIV-infected pregnant women in Bangkok had high-risk HPV types; less than 10% had HPV types 16 or 18. As the HPV prevalence is expected to increase during HIV disease, prophylactic vaccines targeting HPV types 16 and 18 should be studied among HIV-infected women not yet infected with these HPV types and not previously exposed.

Polymerase chain reaction with PGMY09/11 primers showed a 23.4% high-risk human papillomavirus (HPV) prevalence among 256 human immunodeficiency virus-infected pregnant Thai women. This relatively low prevalence is important for planning HPV vaccine studies.

From the *Thailand MOPH–US CDC Collaboration, Nonthaburi, Thailand; † National Center for HIV, STD & TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; ‡ Rajavithi Hospital, Bangkok, Thailand; § Siriraj Hospital, Bangkok, Thailand; and ‖ Columbia University, New York, New York

This research was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the US Department of Energy and the CDC. The authors would like to thank Dr. Frits van Griensven for his helpful suggestions and comments regarding this manuscript.

Correspondence: Liesbeth J. M. Bollen, MD, PhD, Thailand MOPH–U.S. CDC Collaboration, Ministry of Public Health, Soi 4, P.O. Box 139, Nonthaburi 11000, Thailand. E-mail:

Presented in part at the XV International AIDS Conference, July 11–16, 2004, Bangkok, Thailand (abstract MoPeB3291 and MoPeB3292).

Received for publication May 18, 2005, and accepted August 22, 2005.

© Copyright 2006 American Sexually Transmitted Diseases Association