1563. Prevalence of Cervical and Anal High-Risk Human Papillomavirus (HPV) Types covered by Current HPV Vaccines among HIV-Infected Women in the SUN Study
Session: Poster Abstract Session: Clinical Infectious Diseases: Sexually Transmitted Infections
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDSA 2015 Poster final.pdf (444.1 kB)
  • Background:

    Genital HPV infection is highly prevalent and persistent in HIV-infected persons. A quadrivalent HPV vaccine (HPV-4v) is safe and effective among HIV-infected women and protects against high-risk (HR) HPV infections 16 and 18. Recently, a nonavalent HPV vaccine (HPV-9v) targeting HR-HPV types 16, 18, 31, 33, 45, 52, and 58, was approved. We examined the prevalence of these 7 HR-HPV types and associated abnormal cytology to assess the potential impact of the 9v vaccine.

    Methods:

    From 2004 to 2006, the SUN study enrolled 167 women from 7 sites in 4 US cities in a prospective cohort. Providers collected cervical ThinPrep® cytobroom sweeps and Dacron® anal swabs for HPV detection and genotyping, and cytological examination, respectively, from participants every 12-months. We report results through 4 years of follow-up (F/U).

    Results:

    At baseline, in 43 women with data for all 5 visits, median age was 43 years, 51% were non-Hispanic black, 74% had HIV RNA <400 copies/mL, 88% were on cART, and 98% had CD4 cell counts >200 cells/mm3. HPV prevalence at the cervix and anus was 91% at baseline and 56% and 79%, respectively, at 48 months. The proportions of women with type 16 or 18 (HPV-4v) at the cervix and anus were, respectively, 28% and 30% at baseline, and 9% and 14% at 4 years. The proportions with HR-HPV types other than 16 and 18 (additional HR-HPV in HPV-9v) were, respectively, 26% and 35% at baseline, and 16% and 30% at 4 years. The proportions of women infected with any HR-HPV types in HPV-9v at the cervix and anus were, respectively, 53% and 65% at baseline, and 26% and 44% at 4 years. Over F/U, the rate of an abnormality was 51% in 37 women with cervical cytologies and 53% in 43 women with anal cytologies. In women with cervical abnormalities, 74% had HR-HPV types in HPV-9v detected at the same anatomic site; for those with anal abnormalities, 78% had HR-HPV types detected.

    Conclusion:

    In HIV-infected women, prevalence of HPV infection decreased over 4years. While most HR-HPV types detected in abnormal cytologies are covered by HPV-9v, about a quarter of abnormal cervical and a fifth of abnormal anal cytologies had no HR-HPV types covered by the currently available HPV vaccines.  Nonetheless, HPV-9v has potential to prevent a large proportion of cytologic abnormalities.

    Erna Kojic, MD1,2, Lois Conley, MPH3, Tim Bush, MD3, Susan Cu-Uvin, MD4, Elizabeth Unger, MD PhD5, Keith Henry, MD6, John Hammer, MD7, Gerome Escota, MD8, Theresa Darragh, MD9, Joel Palefsky, MD10, John T. Brooks, MD11 and Pragna Patel, MD12, (1)Infectious Diseases, Brown University, Providence, RI, (2)Brown University, Providence, RI, (3)Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, (4)Brown Medical School, Providence, RI, (5)Centers for Disease Control and Prevention, Atlanta, GA, (6)University of Minnesota/HIV program Hennepin County Medical Center, Minneapolis, MN, (7)Infectious Diseases Consults, Denver, CO, (8)Infectious Diseases, Washington University School of Medicine, Saint Louis, MO, (9)University of California, San Francisco, CA, (10)University of California, San Francisco, San Francisco, CA, (11)CDC, Atlanta, GA, (12)Division of HIV/AIDS Prevention, Centers for Disease Prevention and Control, Atlanta, GA

    Disclosures:

    E. Kojic, None

    L. Conley, None

    T. Bush, None

    S. Cu-Uvin, None

    E. Unger, None

    K. Henry, GSK/ViiV: Investigator , Research grant
    Gilead: Investigator , Research grant
    Janssen: Investigator , Research grant
    Merck: Investigator , Research grant

    J. Hammer, None

    G. Escota, None

    T. Darragh, Hologic: Independent research , Research supplies for anal cytology for studies other than this project

    J. Palefsky, Merck and Co.: Board Member and Grant Investigator , Research grant
    Hologic: Grant Investigator , Grant recipient

    J. T. Brooks, None

    P. Patel, None

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