TY - JOUR
T1 - Relationship between smoking and human papillomavirus infections in HIV-infected and -uninfected women
AU - Minkoff, Howard
AU - Feldman, Joseph G.
AU - Strickler, Howard D.
AU - Watts, D. Heather
AU - Bacon, Melanie C.
AU - Levine, Alexandra
AU - Palefsky, Joel M.
AU - Burk, Robert
AU - Cohen, Mardge H.
AU - Anastos, Kathryn
N1 - Funding Information:
Financial support: National Institute of Allergy and Infectious Diseases (to W.I.H.S.); National Cancer Institute (grant R01 CA85178-01), National Institute of Child Health and Human Development (grant U01-HD-32632); National Institute on Drug Abuse; National Institute of Dental Research; Agency for Health Care Policy and Research; Centers for Disease Control and Prevention (grants U01-AI-35004, U01-AI-31834, U01-AI-34994, AI-34989, U01-AI-34993, U01-AI-42590, N01-AI-35161, and MO1 RR00079).
PY - 2004/5/15
Y1 - 2004/5/15
N2 - Background. Smoking may increase the risk of cervical cancer, a disease that is related to human papillomavirus (HPV) infection. However, the effects of smoking on the natural history of HPV are poorly understood, especially in women coinfected with human immunodeficiency virus (HIV). Methods. HIV-infected (n = 1797) and HIV-uninfected (n = 496) women were assessed every 6 months for type-specific HPV DNA. Smoking status was self-reported. Covariates included age, parity, sexual behavior, HIV load, CD4+ T cell count, and antiretroviral therapy. Results. Smoking was positively associated with HPV prevalence at baseline in HIV-infected women (P = .002) and was significantly associated with type-specific HPV detection (e.g., type 18, odds ratio [OR], 2.45; 95% confidence interval [CI], 1.86-3.22). In Cox models, detection of HPV was significantly associated with smoking in HIV-infected women (relative hazard [RH], 1.33; 95% CI, 1.10-1.60; P = .003), but HPV persistence was not (RH, 0.97; 95% CI, 80-1.16; P = .72). The overall likelihood of acquiring persistent HPV was higher in smokers (OR, 1.39; 95% CI, 1.05-1.86; P = .023) because of greater incidence. Conclusions. Among HIV-infected women, smoking is associated with a significantly higher prevalence and incidence of HPV infection. Smoking during HIV infection may alter the natural history of HPV infection and increase the risk of cervical disease.
AB - Background. Smoking may increase the risk of cervical cancer, a disease that is related to human papillomavirus (HPV) infection. However, the effects of smoking on the natural history of HPV are poorly understood, especially in women coinfected with human immunodeficiency virus (HIV). Methods. HIV-infected (n = 1797) and HIV-uninfected (n = 496) women were assessed every 6 months for type-specific HPV DNA. Smoking status was self-reported. Covariates included age, parity, sexual behavior, HIV load, CD4+ T cell count, and antiretroviral therapy. Results. Smoking was positively associated with HPV prevalence at baseline in HIV-infected women (P = .002) and was significantly associated with type-specific HPV detection (e.g., type 18, odds ratio [OR], 2.45; 95% confidence interval [CI], 1.86-3.22). In Cox models, detection of HPV was significantly associated with smoking in HIV-infected women (relative hazard [RH], 1.33; 95% CI, 1.10-1.60; P = .003), but HPV persistence was not (RH, 0.97; 95% CI, 80-1.16; P = .72). The overall likelihood of acquiring persistent HPV was higher in smokers (OR, 1.39; 95% CI, 1.05-1.86; P = .023) because of greater incidence. Conclusions. Among HIV-infected women, smoking is associated with a significantly higher prevalence and incidence of HPV infection. Smoking during HIV infection may alter the natural history of HPV infection and increase the risk of cervical disease.
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U2 - 10.1086/383479
DO - 10.1086/383479
M3 - Article
C2 - 15122518
AN - SCOPUS:2442641332
SN - 0022-1899
VL - 189
SP - 1821
EP - 1828
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 10
ER -