TY - JOUR
T1 - The association of medication use with clearance or persistence of oral HPV infection
AU - Lam, Jennifer O.
AU - Sugar, Elizabeth A.
AU - Cranston, Ross D.
AU - Weber, Kathleen M.
AU - Burk, Robert D.
AU - Wiley, Dorothy J.
AU - Reddy, Susheel
AU - Margolick, Joseph B.
AU - Strickler, Howard D.
AU - Wentz, Alicia
AU - Jacobson, Lisa
AU - Coles, Christian L.
AU - Bream, Jay H.
AU - Rositch, Anne F.
AU - Guo, Yingshi
AU - Xiao, Weihong
AU - Gillison, Maura L.
AU - D’Souza, Gypsyamber
N1 - Funding Information:
This work was supported by Grant R01DE021395 (NIDCR, NIH; Gypsyamber D’Souza). The MACS and WIHS cohorts receive primary funding from NIAID, with additional funding from NCI, NIDA, NIMH and NICHD.
Funding Information:
Oral rinse samples were processed and tested in the laboratory of Dr. Maura Gillison at The Ohio State University. Data were collected by the Multicenter AIDS Cohort Study (MACS). MACS (Principal Investigators): Johns Hopkins University Bloomberg School of Public Health (Joseph Margolick), U01-AI35042; Northwestern University (Steven Wolinsky), U01-AI35039; University of California, Los Angeles (Roger Detels), U01-AI35040; University of Pittsburgh (Charles Rinaldo), U01-AI35041; the Center for Analysis and Management of MACS, Johns Hopkins University Bloomberg School of Public Health (Lisa Jacobson), UM1-AI35043. The MACS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA) and the National Institute of Mental Health (NIMH). The MACS website is located at http://aidscohortstudy.org/ . Data in this manuscript were also collected by the Women’s Interagency HIV Study (WIHS). WIHS (Principal Investigators): U01-AI-103408; Bronx WIHS (Kathryn Anastos), U01-AI-035004; Brooklyn WIHS (Howard Minkoff and Deborah Gustafson), U01-AI-031834; Chicago WIHS (Mardge Cohen and Audrey French), U01-AI-034989; WIHS Data Management and Analysis Center (Stephen Gange and Elizabeth Golub), U01-AI-042590. The WIHS is funded primarily by the National Institute of Allergy and Infectious Diseases (NIAID), with additional co-funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA) and the National Institute on Mental Health (NIMH).
Publisher Copyright:
© 2016, Springer International Publishing Switzerland.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Purpose: Persistent oral human papillomavirus (HPV) infection increases risk for oropharyngeal carcinoma, and people living with HIV have higher rates of oral HPV infection and related cancers. Some prescription medications have immunomodulatory effects, but the impact of medication use on oral HPV natural history is unknown. Methods: Scope® oral rinse-and-gargle samples were collected semi-annually from 1,666 participants and tested for 37 types of oral HPV DNA using PCR; 594 HPV-infected participants with 1,358 type-specific oral HPV infections were identified. Data were collected on recent (past 6 months) use of medications. The relationship between medication use and oral HPV clearance was evaluated using Wei–Lin–Weissfeld regression, adjusting for biologic sex, prevalent versus incident infection, age, HIV status and CD4+ T cell count. Results: Out of 11 medications examined, oral HPV clearance was significantly reduced in participants reporting recent use of antipsychotics (HR 0.75, 95% CI 0.57–0.99), anxiolytics/sedatives (HR 0.78, 95% CI 0.63–0.96) and antidepressants (HR 0.82, 95% CI 0.67–0.999). Among antipsychotics users, effect modification by HIV status was observed, with reduced clearance in HIV-infected (HR 0.67, 95% CI 0.49–0.91), but not HIV-uninfected participants (p-interaction = 0.009). After adjusted analysis, antipsychotic use remained significantly associated with reduced oral HPV clearance overall (aHR 0.75, 95% CI 0.57–0.99), and when restricted to only HIV-infected participants (aHR 0.66, 95% CI 0.48–0.90). After adjustment, anxiolytic/sedative use and antidepressant use were no longer significantly associated with reduced oral HPV clearance. Conclusions: Some medications were associated with decreased oral HPV clearance, most notably antipsychotic medications. These medications are prescribed for conditions that may have immunomodulating effects, so characteristics of underlying illness may have partially contributed to reduced oral HPV clearance.
AB - Purpose: Persistent oral human papillomavirus (HPV) infection increases risk for oropharyngeal carcinoma, and people living with HIV have higher rates of oral HPV infection and related cancers. Some prescription medications have immunomodulatory effects, but the impact of medication use on oral HPV natural history is unknown. Methods: Scope® oral rinse-and-gargle samples were collected semi-annually from 1,666 participants and tested for 37 types of oral HPV DNA using PCR; 594 HPV-infected participants with 1,358 type-specific oral HPV infections were identified. Data were collected on recent (past 6 months) use of medications. The relationship between medication use and oral HPV clearance was evaluated using Wei–Lin–Weissfeld regression, adjusting for biologic sex, prevalent versus incident infection, age, HIV status and CD4+ T cell count. Results: Out of 11 medications examined, oral HPV clearance was significantly reduced in participants reporting recent use of antipsychotics (HR 0.75, 95% CI 0.57–0.99), anxiolytics/sedatives (HR 0.78, 95% CI 0.63–0.96) and antidepressants (HR 0.82, 95% CI 0.67–0.999). Among antipsychotics users, effect modification by HIV status was observed, with reduced clearance in HIV-infected (HR 0.67, 95% CI 0.49–0.91), but not HIV-uninfected participants (p-interaction = 0.009). After adjusted analysis, antipsychotic use remained significantly associated with reduced oral HPV clearance overall (aHR 0.75, 95% CI 0.57–0.99), and when restricted to only HIV-infected participants (aHR 0.66, 95% CI 0.48–0.90). After adjustment, anxiolytic/sedative use and antidepressant use were no longer significantly associated with reduced oral HPV clearance. Conclusions: Some medications were associated with decreased oral HPV clearance, most notably antipsychotic medications. These medications are prescribed for conditions that may have immunomodulating effects, so characteristics of underlying illness may have partially contributed to reduced oral HPV clearance.
KW - Antipsychotic
KW - Clearance
KW - HIV
KW - Immunomodulatory
KW - Oral HPV
KW - Prescription medication
UR - http://www.scopus.com/inward/record.url?scp=84994174462&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84994174462&partnerID=8YFLogxK
U2 - 10.1007/s10552-016-0826-2
DO - 10.1007/s10552-016-0826-2
M3 - Article
C2 - 27804058
AN - SCOPUS:84994174462
VL - 27
SP - 1491
EP - 1498
JO - Cancer Causes and Control
JF - Cancer Causes and Control
SN - 0957-5243
IS - 12
ER -
