People with genital human papillomavirus (HPV) infection run a doubled risk of becoming infected with HIV, according to results of a six-study meta-analysis. The findings have implications for HPV vaccine policy and HIV prevention worldwide.
It is biologically plausible that HPV infection raises the risk of HIV infection, though further research is required to define the mechanism.
The association between HIV acquisition and HPV has received some attention in recent years. To get a deeper understanding of that association, researchers conducted a systematic review and meta-analysis of relevant studies.
The investigators searched scientific databases and conference abstracts to identify all studies published through January 2012 that reported HIV incidence in people with genital HPV infection. Of the 2601 abstracts identified, the researchers focused on six observational studies involving 6567 participants.
Random-effect meta-analysis determined that HPV infection nearly doubled the odds of HIV acquisition (summary odds ratio [OR] 1.96, 95% confidence interval [CI] 1.55 to 2.49). HIV acquisition was significantly associated with high-risk (cancer-causing) HPV genotypes in five of six studies and with low-risk HPV genotypes in two of five studies.
The association between HPV and HIV acquisition was significant for high-risk HPV (summary OR 1.92, 95% CI 1.49 to 2.46). The association was borderline for low-risk HPV (summary OR 1.53, 95% CI, 0.96 to 2.42).
The authors conclude that “HPV infection may be a risk factor of HIV acquisition.” They call for research to “assess the effect of HPV vaccination on HIV acquisition, using vaccines with broad coverage of HPV genotypes.” Two HPV vaccines are available, one targeting two high-risk HPV types and one targeting two high-risk types and two types that cause genital warts. A vaccine targeting nine HPV types is in development.
