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Session 26 Oral Abstract Session Pediatric/Maternal-Fetal HIV Infection and Issues in HIV-Infected Women Session Time: Wednesday, 10 am - 12:30 pm Room 606-609

12:00   119. Lack of Effect of HAART on HPV DNA Levels in the Female Genital Tract L. J. Conley1, T. J. Bush1, T. V. Ellerbrock*1, J. Lennox2, F. Wu3, T. Evans-Strickfaden1, C. E. Hart1, and T. C. Wright3 1CDC, Atlanta, GA and 2Emory Univ., Atlanta, GA; and 3Columbia Univ., New York, NY Background: HIV-infected women are at increased risk for HPV-associated cervical carcinoma. This study was done to assess the effect of HAART on HPV load in vaginal secretions. Methods: Plasma HIV-1 RNA and vaginal lavage HPV DNA specimens were obtained at 345 visits (range 3-17) from 44 HIV-infected women. At each visit, plasma HIV-1 RNA was quantified using a QC-PCR assay, vaginal HPV DNA was quantified using the microtiter Hybrid Capture II assay (Digene Corporation), and CD4+ T-lymphocyte count was determined. To measure the impact of HAART on HPV load, the changes in vaginal HPV loads between visits before and after starting HAART were compared to the changes in HPV virus loads from one visit to the next for all other visits. To allow for variability in the assay, a change was defined as > 0.5 log10. In a repeated measures analysis, changes in plasma HIV-1 levels, vaginal HPV loads, and CD4+ count between baseline visits and both 2-week and 6-month visits were compared for women who initiated HAART and those on no HAART. Results: In 42 first visits after starting HAART, 11 (26%) increased, 10 (24%) decreased, and 21 (50%) had no change in vaginal HPV DNA loads, while in 237 visits where HAART had not been initiated, 46 (19%) increased, 39 (16%) decreased, and 152 (64%) remained unchanged (p=0.22). For 18 women who were not on HAART, the median vaginal HPV loads, plasma HIV-1 levels, and CD4+ counts at baseline were not significantly different from that at the 2-week or 6-month visits (p>0.05). For 10 women, who had undetectable plasma HIV RNA for at least 6 months after starting HAART, vaginal HPV loads and CD4+ counts at baseline were not significantly different from that at the 2-week or 6-month visits (p>0.05), while plasma HIV-1 levels at baseline decreased significantly at both 2 weeks and 6 months (p<0.05). Conclusions: These findings indicate that HAART does not have an effect on vaginal HPV load in the female genital tract, suggesting that the high incidence of cervical disease in HIV-infected women may persist for those on HAART.

©2002 9th Conference on Retroviruses and Opportunistic Infections