HPV infection and the genital cytokine milieu in women at high risk of HIV acquisition

Lenine J P Liebenberg,Leila E Mansoor,Jo-Ann S Passmore,Salim S Abdool Karim,Cheryl Baxter,Nigel Garrett,Ayesha B M Kharsany,Anne Rositch,Quarraisha Abdool Karim,Derseree Archary,Nonhlanhla Yende-Zuma,Lyle R Mckinnon,Natasha Samsunder

doi:10.1038/s41467-019-13089-2

Abstract

Human papillomavirus (HPV) infection correlates with higher rates of HIV acquisition, but the underlying biological mechanisms are unclear. Here we study associations between HPV and HIV acquisition and relate these to vaginal cytokine profiles in an observational cohort of women at high risk of HIV infection (CAPRISA 004, n = 779) and with 74% HPV prevalence. We report here that HPV infection associates with a 2.5-fold increase in HIV acquisition risk in this population (95% CI: 1.2–5.3). Among 48 vaginal cytokines profiled, cytokines associated with HPV infection overlap substantially with cytokines associated with HIV risk, but are distinct from those observed in HPV negative women. Although our data do not establish a causative link between HPV status and the risk of HIV, we suggest that increasing HPV vaccination coverage may carry an additional benefit of reducing the risk of contracting HIV infection, particularly in regions with high HPV prevalence.

Highlights

Human papillomavirus (HPV) infection correlates with higher rates of human immunodeficiency virus (HIV) acquisition, but the underlying biological mechanisms are unclear
HPV DNA was detected in 73.8% of participants at baseline (HPV+; Table 1)
The factors associated with HPV status were younger age, marital status (4.0% married vs. 11.8% unmarried, p < 0.001; Fisher’s exact test), living away from the regular sex partner (89.5% HPV+ vs. 80.8% HPV−, p < 0.001; Fisher’s exact test), and baseline infection with Chlamydia trachomatis (15.9% HPV+ vs. 4.3% HPV−, p = 0.003; Fisher’s exact test; Table 1)

Summary

Introduction

Human papillomavirus (HPV) infection correlates with higher rates of HIV acquisition, but the underlying biological mechanisms are unclear. We study associations between HPV and HIV acquisition and relate these to vaginal cytokine profiles in an observational cohort of women at high risk of HIV infection (CAPRISA 004, n = 779) and with 74% HPV prevalence. We report here that HPV infection associates with a 2.5-fold increase in HIV acquisition risk in this population (95% CI: 1.2–5.3). Because the risk of HPV infection is known to be very high following sexual debut[12], efforts are underway to implement these vaccines in young women worldwide, as the degree of protection is much higher in HPV uninfected individuals. In addition to its role as a major factor in the development of cervical and several anogenital cancers, HPV has been associated with increased risk of HIV acquisition[17,18].

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Results

Conclusion