Human Papillomavirus Viral Load and Transmission in Young, Recently Formed Heterosexual Couples
JOURNAL OF INFECTIOUS DISEASES
Authors: Wissing, Michel D.; Louvanto, Karolina; Comete, Emilie; Burchell, Ann N.; El-Zein, Mariam; Rodrigues, Allita; Tellier, Pierre-Paul; Coutlee, Francois; Franco, Eduardo L.
Abstract
Background. We studied the association between human papillomavirus (HPV) viral load (VL) and HPV concordance. Methods. The HITCH cohort study included young, heterosexual, recently formed, sexually active couples. Questionnaires and genital samples were collected at 0 and 4 months. Samples were tested for HPV DNA by polymerase chain reaction (PCR; Linear Array). VLs of HPV6/11/16/18/31/42/51 were quantified using type-specific real-time PCR. Correlations between VL and typespecific HPV prevalence and incidence were evaluated using multilevel, mixed-effects linear/logistic regression models. Results. We included 492 couples. VLs were higher in penile than vaginal samples. VL at subsequent visits correlated significantly within men (r, 0.373), within women (r, 0.193), and within couples (r range: 0.303-0.328). Men with high VL had more typespecific persistent HPV infections (odds ratio [OR], 4.6 [95% confidence interval {CI}, 2.0-10.5]). High VL in men was associated with prevalent (OR, 5.3 [95% CI, 2.5-11.2]) and incident (OR, 6.7 [95% CI, 1.5-30.7]) type-specific HPV infections in their partner. Women's VL was associated with type-specific HPV prevalence in their partner at the same (OR, 5.9) and subsequent (OR, 4.7) visit. Conclusions. Persistent HPV infections have limited VL fluctuations. VL between sex partners are correlated and seem predictive of transmission episodes.
Randomized trial of HPV4 vaccine assessing the response to HPV4 vaccine in two schedules among Peruvian female sex workers
VACCINE
Authors: Brown, Brandon; Blas, Magaly; Cabral, Alejandra; Carcamo, Cesar; Gravitt, Patti; Halsey, Neal
Abstract
Two hundred female sex workers (FSWs) in Lima. Peru were randomized to receive HPV4 vaccine in the standard (0, 2, 6 months) or a modified schedule (0, 3, 6 months). One hundred and eighty four (92%) participants completed 3 doses of vaccine. Baseline seropositive rates were 58% for HPV6, 22.5% for HPV11, 41.5% for HPV16, and 13% for HPV18. The final geometric mean antibody titer (GMT) following vaccination was significantly greater for women who were seropositive at baseline compared to seronegative women: HPV6 (GMT ratio = 2.3, p < 0.01), HPV11 (GMT ratio = 2.7, p < 0.01), HPV16 (GMT ratio = 1.3, p = 0.04), and HPV18 (GMT ratio = 2.4,p < 0.01). Antibody titers in the modified schedule were not inferior to those in the standard schedule, suggesting the modified schedule may be paired with required STD visits. Although all women benefit from vaccination, administration at a younger age and before sexual debut is needed to achieve maximum protection from vaccine. (C) 2012 Elsevier Ltd. All rights reserved.