{"id":2652,"date":"2007-04-04T12:28:14","date_gmt":"2007-04-04T12:28:14","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=2652"},"modified":"2013-09-20T17:33:10","modified_gmt":"2013-09-20T17:33:10","slug":"increased-anal-hpv-levels-in-hv-positive-smokers","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/2652","title":{"rendered":"Increased anal HPV levels in HV-positive smokers"},"content":{"rendered":"

Simon Collins, HIV i-Base<\/strong><\/p>\n

The impact of smoking status on levels of HPV-16 viral load was reported in a poster by Norbert Brockmeyer and colleagues from University of Bochum, Germany in a prospective study of samples from 267 HIV-positive MSM participants in an HPV screening programme, half of whom were smokers.<\/strong><\/p>\n

1806 intraanal and perianal swabs (mean 3.5 per patient) were analysed for HPV genotype and HPV viral load, using real-time PCR (expressed as HPV16 DNA copies per beta-globin gene copy). High risk HPV genotyes were detected in 316 samples (for HPV-16) and 154 (for HPV-18), and at a statistically higher rate in smokers vs non-smokers.<\/p>\n

Normal cytology, low-grade squamous intraepithelial lesions (LSIL), and high-grade squamous intraepithelial lesions (HSIL) were found in 60, 13, and 7% of perianal and in 49, 16, and 9% of intraanal swabs.<\/p>\n

Smokers were at higher risk of HPV DNA, high-risk HPV DNA, and HPV16 DNA compared to non-smokers and had significanty higher levels of perianal and intraanal levels of HPV-16 (see Table 1) and HPV-18 viral load (data not shown). These differences were greater in patients with normal cytology results. The p-value for the effect of smoking remained significant after adjusting for age, CD4, viral load, AIDS and ARV use in a multivariate analysis.<\/p>\n

As an elevated HPV viral load is a risk factor for progression to CIN\/cancer in women with normal cytology, the authors concluded with the importance of emphasising smoking cessation for HIV-positive patients.<\/p>\n

Table 1: Levels of HPV-16 viral load in non-smokers vs current smokers<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
<\/th>\nNon-smokers<\/th>\nCurrent smokers<\/th>\np-value<\/th>\n<\/tr>\n
Anogenital HPV<\/td>\n82%<\/td>\n90%<\/td>\n<\/td>\n<\/tr>\n
High-risk HPV<\/td>\n70%<\/td>\n83%<\/td>\np=0.001<\/td>\n<\/tr>\n
HPV16<\/td>\n48%<\/td>\n54%<\/td>\np=0.182<\/td>\n<\/tr>\n
HPV18<\/td>\n20%<\/td>\n26%<\/td>\np=0.111<\/td>\n<\/tr>\n
Normal cytology<\/td>\n73%<\/td>\n64%<\/td>\n<\/td>\n<\/tr>\n
LSIL or HSIL<\/td>\n27% (46 LSIL + 9 HSIL)<\/td>\n36% (41 LSIL + 40 HSIL)<\/td>\np=0.041<\/td>\n<\/tr>\n
Mean intraanal HPV16 VL<\/td>\n21<\/td>\n318<\/td>\np=0.023<\/td>\n<\/tr>\n
Median intraanal HPV16 VL<\/td>\n0.3<\/td>\n3.7<\/td>\np=0.023<\/td>\n<\/tr>\n
Mean perianal HPV16 VL<\/td>\n013<\/td>\n186<\/td>\np=0.017<\/td>\n<\/tr>\n
Median perianal HPV16 VL<\/td>\n0.2<\/td>\n3.6<\/td>\np=0.017<\/td>\n<\/tr>\n
Mean intraanal HPV16 VL (normal cytology)<\/td>\n1.8<\/td>\n709<\/td>\np=0.004<\/td>\n<\/tr>\n
Mean intraanal HPV16 VL (all grades)<\/td>\n4.5<\/td>\n81.5<\/td>\np=0.094<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Comment<\/h3>\n

Several other posters reported immunological impact of smoking on HIV-positive patients. <\/strong><\/p>\n

Apart from the expected links reported in studies looking at risk of cardiovascular disease (see D:A:D reports in this issue of HTB), these included reduced responses from hepatitis A vaccinations (smoking was an independent predictor of non-response to vaccine; 0R = 2.78, 95%CI 1.03 to 7.69, p = 0.02) [2], higher levels of oxidative stress [3], higher risk of fatal AIDS-defining malignancies (2.42; p <0.0001; not significant if lung cancers were excluded) [4], and reduced responses to prime-boost pneumococcal vaccine strategies. [5]<\/strong><\/p>\n

The report from D:A:D highlighted particularly low reports of smoking cessation even in patients diagnosed with a CVD event.<\/strong><\/p>\n

References:<\/p>\n

    \n
  1. Norbert Brockmeyer N, Kreuter A, Pfister H et al. Elevated Anal HPV16 DNA Loads in HIV+ Men Who Smoke. Poster 872.
    \nhttp:\/\/www.retroconference.org\/2007\/Abstracts\/28999.htm<\/a>     http:\/\/www.retroconference.org\/2007\/PDFs\/872.pdf<\/a><\/li>\n
  2. Launay O, Grabar S, Gordien E et al. Randomized Trial Comparing a 3-Dose Regimen to a Standard 2- Dose Regimen of Hepatitis A Vaccine in HIV-infected Adult Patients with CD4+ T Cells between 200 and 500 per mm3 (HEPAVAC Study). Poster 885.
    \n    http:\/\/www.retroconference.org\/2007\/Abstracts\/29143.htm<\/a><\/li>\n
  3. Dageforde LA, Shintani A, Haas D et al. NNRTI Use May Be Associated with Decreased Oxidant Stress during HIV Therapy. Poster 798.
    \nhttp:\/\/www.retroconference.org\/2007\/Abstracts\/29674.htm<\/a><\/li>\n
  4. D\u0092Arminio Monforte A, Abrams D, Pradier C et al. HIV-induced Immunodeficiency and Risk of Fatal AIDS-defining and Non-AIDS-defining Malignancies: Results from the D:A:D Study. Oral abstract 84.
    \n    http:\/\/www.retroconference.org\/2007\/Abstracts\/28927.htm<\/a><\/li>\n
  5. L\u00e9vy G, Tsch I, Lesprit P el at. Long-term Immunologenicity of a Prime-boost Strategy Combining a 7-Valent Pneumococcal Conjugate Vaccine followed by a 23-Valent Pneumococcal Polysaccharide Vaccine vs PPV Alone: ANRS 114 Pneumovac Study. Poster 866.
    \nhttp:\/\/www.retroconference.org\/2007\/Abstracts\/29394.htm<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Simon Collins, HIV i-Base The impact of smoking status on levels of HPV-16 viral load was reported in a poster by Norbert Brockmeyer and colleagues from University of Bochum, Germany in a prospective study of samples from 267 HIV-positive MSM …<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,18],"tags":[61],"class_list":["post-2652","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-cancer-and-hiv","tag-croi-2007"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2652","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=2652"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2652\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=2652"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=2652"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=2652"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}