Relationship between smoking and human papillomavirus infections in HIV-infected and -uninfected women

Howard Minkoff, Joseph G. Feldman, Howard Strickler, D. Heather Watts, Melanie C. Bacon, Alexandra Levine, Joel M. Palefsky, Robert D. Burk, Mardge H. Cohen, Kathryn Anastos

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1821-1828
Number of pages8
JournalJournal of Infectious Diseases
Volume189
Issue number10
DOIs
StatePublished - May 15 2004

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Papillomavirus Infections
Smoking
HIV
Confidence Intervals
Natural History
Odds Ratio
Incidence
Virus Diseases
CD4 Lymphocyte Count
Parity
Proportional Hazards Models
Uterine Cervical Neoplasms
Sexual Behavior
T-Lymphocytes

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Relationship between smoking and human papillomavirus infections in HIV-infected and -uninfected women. / Minkoff, Howard; Feldman, Joseph G.; Strickler, Howard; Watts, D. Heather; Bacon, Melanie C.; Levine, Alexandra; Palefsky, Joel M.; Burk, Robert D.; Cohen, Mardge H.; Anastos, Kathryn.

In: Journal of Infectious Diseases, Vol. 189, No. 10, 15.05.2004, p. 1821-1828.

Research output: Contribution to journalArticle

Minkoff, Howard ; Feldman, Joseph G. ; Strickler, Howard ; Watts, D. Heather ; Bacon, Melanie C. ; Levine, Alexandra ; Palefsky, Joel M. ; Burk, Robert D. ; Cohen, Mardge H. ; Anastos, Kathryn. / Relationship between smoking and human papillomavirus infections in HIV-infected and -uninfected women. In: Journal of Infectious Diseases. 2004 ; Vol. 189, No. 10. pp. 1821-1828.
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abstract = "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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AU - Feldman, Joseph G.

AU - Strickler, Howard

AU - Watts, D. Heather

AU - Bacon, Melanie C.

AU - Levine, Alexandra

AU - Palefsky, Joel M.

AU - Burk, Robert D.

AU - Cohen, Mardge H.

AU - Anastos, Kathryn

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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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