The approach to individualized prediction of human papillomavirus (HPV) infection persistence/clearance in HIV-1-positive adolescent girls based on dynamics of CD4+ counts, viral load, and HAART
© Kravchenko et al; licensee BioMed Central Ltd. 2010
Published: 11 October 2010
Several studies suggest that CD4+ T-cell count (CD4) is important in pathogenesis of human papillomavirus (HPV) infection in HIV-positive patients including HPV clearance. CD4 dynamics as well as other co-factors such as highly active antiretroviral therapy (HAART), HIV-1 RNA viral load (VL), demographics, behavioral risks and, clinical diagnosis allows for predicting the absolute probabilities of HPV clearance/persistence. The modeling approach allows for the utilization of complete datasets and does not require any additional essential assumptions about missing information and possible violations in study design.
Materials and methods
We analyzed 266 HIV-1 positive adolescent girls from the Reaching for Excellence in Adolescent Care and Health (REACH) cohort. At enrollment and every 6 months thereafter, cervical lavage samples were tested for HPV using MY09/MY11/HMB01-based PCR and 30 HPV type-specific probes. HIV-related clinical data and risk factors were recorded every 3 months. For analytic purposes, HPV types were categorized according to phylogenetic patterns into (1) 16/16-like, (2) 18/18-like, (3) other high risk (56/56-like), and (4) low risk. HPV clearance was defined by the absence of type-specific infection for two subsequent visits after infection. Maximum likelihood estimates based on the logistic-type model were developed for 3-month reconstructed probabilities of HPV clearance/persistent with CD4, VL, and HAART as the main predictors at the moment of examination.
This approach could extend opportunities to understand the associations between CD4, VL, and HAART to develop the comprehensive approach to individualized prediction of HPV infection persistence/clearance in HIV-positive patients.
This article has been published as part of Infectious Agents and Cancer Volume 5 Supplement 1, 2010: Proceedings of the 12th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI).The full contents of the supplement are available online at http://www.biomedcentral.com/1750-9378/5?issue=S1.
This article is published under license to BioMed Central Ltd.