{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,4,2]],"date-time":"2022-04-02T19:59:00Z","timestamp":1648929540836},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infect Agents Cancer"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>HIV-positive women are at increased risk of human papillomavirus (HPV) infection, and, especially, multiple infections compared to HIV-negative women. Whether certain HPV types have a tendency to cluster in multiple infections beyond or below what would be expected by shared risk factors (e.g., sexual behavior and the degree of immunosuppression) is unclear. We, therefore, investigated clustering patterns of 44 HPV types in HIV-positive women from Kenya.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Findings<\/jats:title>\n            <jats:p>HPV status was assessed on cervical scrapings from 498 women using GP5+\/6+ PCR and reverse line blot. Logistic regression was used to model type-specific HPV positivity, adjusted for age, specific HPV type prevalence, CD4, combination antiretroviral therapy, and, in the Full Model, individual-level random effects that represent unobservable risk factors common to all HPV types. We found a modest excess of women with co-infections with 2 HPV types (1.12; 95% credible intervals: 1.03-1.21) in the Full Model but no significant associations of individual types. No significant deviations of observed\/expected counts were observed for any 2-way combination of HPV types at either the chosen level of significance, p\u2009=\u20090.00005, or at p\u2009=\u20090.01. Findings were substantially similar when women with CIN2\/3 were excluded and when they were stratified by use of anti-retroviral therapy or CD4 count.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>HPV co-infections occurred at random in the cervix of HIV-positive women as previously found in HIV-negative women. The removal of HPV types through vaccination should not result, therefore, in an increase or decrease in the prevalence of HPV types not targeted by vaccination in immunosuppressed women.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1750-9378-8-50","type":"journal-article","created":{"date-parts":[[2013,12,19]],"date-time":"2013-12-19T12:07:25Z","timestamp":1387454845000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clustering patterns of human papillomavirus infections among HIV-positive women in Kenya"],"prefix":"10.1186","volume":"8","author":[{"given":"Salvatore","family":"Vaccarella","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"De Vuyst","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelly R","family":"Mugo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samah R","family":"Sakr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martyn","family":"Plummer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dani\u00eblle A M","family":"Heideman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Franceschi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Chung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,12,19]]},"reference":[{"key":"476_CR1","doi-asserted-by":"publisher","first-page":"2337","DOI":"10.1097\/01.aids.0000253361.63578.14","volume":"20","author":"GM Clifford","year":"2006","unstructured":"Clifford GM, Goncalves MA: Franceschi S, for the HPV and HIV Study Group: human papillomavirus types among women infected with HIV: a meta-analysis. AIDS. 2006, 20: 2337-2344. 10.1097\/01.aids.0000253361.63578.14.","journal-title":"AIDS"},{"key":"476_CR2","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1097\/CEJ.0b013e3282f75ea1","volume":"17","author":"H De Vuyst","year":"2008","unstructured":"De Vuyst H, Lillo F, Broutet N, Smith JS: HIV, human papillomavirus, and cervical neoplasia and cancer in the era of highly active antiretroviral therapy. Eur J Cancer Prev. 2008, 17: 545-554. 10.1097\/CEJ.0b013e3282f75ea1.","journal-title":"Eur J Cancer Prev"},{"key":"476_CR3","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1158\/1055-9965.EPI-09-0983","volume":"19","author":"S Vaccarella","year":"2010","unstructured":"Vaccarella S, Franceschi S, Snijders PJ, Herrero R, Meijer CJ, Plummer M: Concurrent infection with multiple human papillomavirus types: pooled analysis of the IARC HPV Prevalence Surveys. 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Br J Cancer. 2012, 107: 1624-1630. 10.1038\/bjc.2012.441.","journal-title":"Br J Cancer"},{"key":"476_CR11","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1097\/QAD.0b013e32834a3654","volume":"25","author":"MH Chung","year":"2011","unstructured":"Chung MH, McKenzie KP, Richardson BA, John-Stewart GC, Coombs RW, De Vuyst H, Njoroge JW, Nyongesa-Malava E, Sakr SR, Mugo NR: Cervical HIV-1 RNA shedding after cryotherapy among HIV-positive women with cervical intraepithelial neoplasia stage 2 or 3. AIDS. 2011, 25: 1915-1919. 10.1097\/QAD.0b013e32834a3654.","journal-title":"AIDS"},{"key":"476_CR12","volume-title":"AIDS","author":"MH Chung","year":"2013","unstructured":"Chung MH, McKenzie KP, De Vuyst H, Richardson BA, Rana FS, Pamnani R, Njoroge JW, Nyongesa-Malava E, Sakr SR, John-Stewart GC, Mugo NR: Comparing pap smear, via, and hpv cervical cancer screening methods among hiv-positive women by immune status, and antiretroviral therapy. 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