Association of cutaneous anergy with human papillomavirus and cervical neoplasia in HIV-seropositive and seronegative women

Tiffany G. Harris, Robert D. Burk, Xiaonan (Nan) Xue, Kathryn Anastos, Howard Minkoff, L. Stewart Massad, Mary A. Young, Alexandra M. Levine, Stephen J. Gange, D. Heather Watts, Joel M. Palefsky, Howard Strickler

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

OBJECTIVE: Cutaneous anergy testing evaluates delayed type hypersensitivity responses and is, in essence, an in-vivo measure of cell-mediated immune function at an epithelial surface. This study assessed the relationship of anergy test results with cervical infection by human papillomavirus (HPV) and cervical neoplasia in HIV-seropositive and seronegative women. METHODS: HIV-seropositive (n = 1029) and HIV-seronegative (n = 272) women enrolled in a long-term cohort study were followed semi-annually with HPV-DNA testing and cytology. Anergy was defined as unresponsiveness to Candida albicans, tetanus toxoid, and mumps antigen. RESULTS: Anergy was associated with the prevalent detection of squamous intraepithelial lesions [SIL; adjusted odds ratio 1.70; 95% confidence interval (CI) 1.16-2.48] in multivariable logistic regression models, and with the incident detection of oncogenic HPV (adjusted hazard ratio 1.24; 95% CI 0.99-1.56) in multivariable Cox regression models. These models adjusted for HIV infection, combined CD4 T-cell and HIV-RNA strata (13 separate strata to control optimally for their interactive effects), as well as other variables. CONCLUSION: Cutaneous anergy testing may measure aspects of local cellular immune function in epithelial tissues that are important for the control of HPV and development of SIL, and that in HIV-seropositive women are not fully accounted for by circulating CD4 T-cell counts and HIV-RNA levels.

Original languageEnglish (US)
Pages (from-to)1933-1941
Number of pages9
JournalAIDS
Volume21
Issue number14
DOIs
StatePublished - Sep 2007

Fingerprint

HIV
Skin
Neoplasms
Logistic Models
RNA
Confidence Intervals
T-Lymphocytes
Mumps
Tetanus Toxoid
Papillomavirus Infections
Delayed Hypersensitivity
Human Development
CD4 Lymphocyte Count
Candida albicans
Proportional Hazards Models
HIV Infections
Cell Biology
Cohort Studies
Epithelium
Odds Ratio

Keywords

  • Anergy
  • CD4 T-lymphocyte count
  • Cellular immunity
  • HIV
  • Human papillomavirus

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Association of cutaneous anergy with human papillomavirus and cervical neoplasia in HIV-seropositive and seronegative women. / Harris, Tiffany G.; Burk, Robert D.; Xue, Xiaonan (Nan); Anastos, Kathryn; Minkoff, Howard; Massad, L. Stewart; Young, Mary A.; Levine, Alexandra M.; Gange, Stephen J.; Watts, D. Heather; Palefsky, Joel M.; Strickler, Howard.

In: AIDS, Vol. 21, No. 14, 09.2007, p. 1933-1941.

Research output: Contribution to journalArticle

Harris, Tiffany G. ; Burk, Robert D. ; Xue, Xiaonan (Nan) ; Anastos, Kathryn ; Minkoff, Howard ; Massad, L. Stewart ; Young, Mary A. ; Levine, Alexandra M. ; Gange, Stephen J. ; Watts, D. Heather ; Palefsky, Joel M. ; Strickler, Howard. / Association of cutaneous anergy with human papillomavirus and cervical neoplasia in HIV-seropositive and seronegative women. In: AIDS. 2007 ; Vol. 21, No. 14. pp. 1933-1941.
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abstract = "OBJECTIVE: Cutaneous anergy testing evaluates delayed type hypersensitivity responses and is, in essence, an in-vivo measure of cell-mediated immune function at an epithelial surface. This study assessed the relationship of anergy test results with cervical infection by human papillomavirus (HPV) and cervical neoplasia in HIV-seropositive and seronegative women. METHODS: HIV-seropositive (n = 1029) and HIV-seronegative (n = 272) women enrolled in a long-term cohort study were followed semi-annually with HPV-DNA testing and cytology. Anergy was defined as unresponsiveness to Candida albicans, tetanus toxoid, and mumps antigen. RESULTS: Anergy was associated with the prevalent detection of squamous intraepithelial lesions [SIL; adjusted odds ratio 1.70; 95{\%} confidence interval (CI) 1.16-2.48] in multivariable logistic regression models, and with the incident detection of oncogenic HPV (adjusted hazard ratio 1.24; 95{\%} CI 0.99-1.56) in multivariable Cox regression models. These models adjusted for HIV infection, combined CD4 T-cell and HIV-RNA strata (13 separate strata to control optimally for their interactive effects), as well as other variables. CONCLUSION: Cutaneous anergy testing may measure aspects of local cellular immune function in epithelial tissues that are important for the control of HPV and development of SIL, and that in HIV-seropositive women are not fully accounted for by circulating CD4 T-cell counts and HIV-RNA levels.",
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T1 - Association of cutaneous anergy with human papillomavirus and cervical neoplasia in HIV-seropositive and seronegative women

AU - Harris, Tiffany G.

AU - Burk, Robert D.

AU - Xue, Xiaonan (Nan)

AU - Anastos, Kathryn

AU - Minkoff, Howard

AU - Massad, L. Stewart

AU - Young, Mary A.

AU - Levine, Alexandra M.

AU - Gange, Stephen J.

AU - Watts, D. Heather

AU - Palefsky, Joel M.

AU - Strickler, Howard

PY - 2007/9

Y1 - 2007/9

N2 - OBJECTIVE: Cutaneous anergy testing evaluates delayed type hypersensitivity responses and is, in essence, an in-vivo measure of cell-mediated immune function at an epithelial surface. This study assessed the relationship of anergy test results with cervical infection by human papillomavirus (HPV) and cervical neoplasia in HIV-seropositive and seronegative women. METHODS: HIV-seropositive (n = 1029) and HIV-seronegative (n = 272) women enrolled in a long-term cohort study were followed semi-annually with HPV-DNA testing and cytology. Anergy was defined as unresponsiveness to Candida albicans, tetanus toxoid, and mumps antigen. RESULTS: Anergy was associated with the prevalent detection of squamous intraepithelial lesions [SIL; adjusted odds ratio 1.70; 95% confidence interval (CI) 1.16-2.48] in multivariable logistic regression models, and with the incident detection of oncogenic HPV (adjusted hazard ratio 1.24; 95% CI 0.99-1.56) in multivariable Cox regression models. These models adjusted for HIV infection, combined CD4 T-cell and HIV-RNA strata (13 separate strata to control optimally for their interactive effects), as well as other variables. CONCLUSION: Cutaneous anergy testing may measure aspects of local cellular immune function in epithelial tissues that are important for the control of HPV and development of SIL, and that in HIV-seropositive women are not fully accounted for by circulating CD4 T-cell counts and HIV-RNA levels.

AB - OBJECTIVE: Cutaneous anergy testing evaluates delayed type hypersensitivity responses and is, in essence, an in-vivo measure of cell-mediated immune function at an epithelial surface. This study assessed the relationship of anergy test results with cervical infection by human papillomavirus (HPV) and cervical neoplasia in HIV-seropositive and seronegative women. METHODS: HIV-seropositive (n = 1029) and HIV-seronegative (n = 272) women enrolled in a long-term cohort study were followed semi-annually with HPV-DNA testing and cytology. Anergy was defined as unresponsiveness to Candida albicans, tetanus toxoid, and mumps antigen. RESULTS: Anergy was associated with the prevalent detection of squamous intraepithelial lesions [SIL; adjusted odds ratio 1.70; 95% confidence interval (CI) 1.16-2.48] in multivariable logistic regression models, and with the incident detection of oncogenic HPV (adjusted hazard ratio 1.24; 95% CI 0.99-1.56) in multivariable Cox regression models. These models adjusted for HIV infection, combined CD4 T-cell and HIV-RNA strata (13 separate strata to control optimally for their interactive effects), as well as other variables. CONCLUSION: Cutaneous anergy testing may measure aspects of local cellular immune function in epithelial tissues that are important for the control of HPV and development of SIL, and that in HIV-seropositive women are not fully accounted for by circulating CD4 T-cell counts and HIV-RNA levels.

KW - Anergy

KW - CD4 T-lymphocyte count

KW - Cellular immunity

KW - HIV

KW - Human papillomavirus

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