Grant Number:	5R01CA062801-05 Interpret this number
Primary Investigator:	Kiviat, Nancy
Organization:	University Of Washington
Project Title:	Natural History of Cervical Neoplasia in HIV-1 and HIV 2
Fiscal Year:	1998

Human papillomavirus (HPV) infection is though to play a central role in the development of cancers and those precancerous lesions of the cervix (cervical intraepithelial neoplasia grade 2-3[CIN2-3] most likely to develop into invasive cancer. More recently, cross sectional studies have shown HIV infection to be associated with an increased risk of such HPV-related lesions. Invasive cervical cancer is now considered an AIDs defining illness among HIV infected women. However, cohort studies are needed to define the absolute risk of CIN2-3 in women with HIV infection, to characterize the role of specific types of HPV and the role of potential cofactors in development of CIN2-3 in HIV infected women, and to compare efficacy of ablative therapy for CIN2-3 among women with and without HIV. Our cross sectional study in Senegal, now beginning its fourth and last clinical year, is the only study currently examining both HIV-1 and HIV-2 with respect to the prevalence of HPV and CIN. We have established an infrastructure that will facilitate longitudinal studies of the development and recurrence, after treatment, of CIN2-3. Thus, we propose to extend the findings of our cross-sectional study by conducting a cohort study of women with and without HIV-1 and HIV-2 at our present study sites. Senegal is the ideal site for the proposed study since HIV- 1 and HIV-2 are equally prevalent, but dual HIV-1/2 infection is uncommon. We propose to 1) compare the risk of development of biopsy proven CIN2-3 in relationship to HIV-1 and/or HIV-2 among HPV positive women; 2) to characterize the risk of development of CIN2-3 among HIV infected women with respect to the role of HPV, specific types of HPV, and among HPV positive women, with respect to infection with other STDs; 3) to assess the influence of HIV-1 and/or HIV-2 on the natural history of cervical HPV; and 4) to compare the outcome of ablative treatment of CIN2-3 among women with and without HIV with respect to the risk of recurrence of CIN1 and CIN2-3. We will enroll and follow 900 cytologically negative women including 300 women with HIV-1, 300 with HIV-2, and 300 HIV seronegative /HPV positive women. In addition, 327 women with and without HIV who have been treated by conization for CIN2-3 will be enrolled. Women will be examined every four months for 3 years by colposcopy, cytology, and tested for HPV, other STDs and CD4 levels. Knowledge from the proposed study will aid in the development of strategies for cervical cancer prevention among HIV infected women.




HIV and the dual burden of malnutrition in Senegal, 1994-2012.
Authors: Benzekri N.A. , Seydi M. , NDoye I. , Toure M. , Kiviat N.B. , Sow P.S. , Hawes S.E. , Gottlieb G.S. .
Source: International journal of STD & AIDS, 2018 10; 29(12), p. 1165-1173.
EPub date: 2018-06-18.
PMID: 29914295
Related Citations

A Comparison of the Natural History of HPV Infection and Cervical Abnormalities among HIV-Positive and HIV-Negative Women in Senegal, Africa.
Authors: Whitham H.K. , Hawes S.E. , Chu H. , Oakes J.M. , Lifson A.R. , Kiviat N.B. , Sow P.S. , Gottlieb G.S. , Ba S. , Sy M.P. , et al. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2017 06; 26(6), p. 886-894.
EPub date: 2017-05-17.
PMID: 28515108
Related Citations

The association between HPV, intraepithelial lesions and HIV-1 shedding in anogenital specimens in two contrasting populations: Senegalese women and American MSM.
Authors: Hood J.E. , Gottlieb G.S. , Kiviat N.B. , Sow P.S. , Toure M. , Feng Q. , Hawes S.E. .
Source: International journal of STD & AIDS, 2016 Apr; 27(5), p. 353-62.
EPub date: 2015-04-24.
PMID: 25914409
Related Citations

HIV-1 outcompetes HIV-2 in dually infected Senegalese individuals with low CD4⁺ cell counts.
Authors: Raugi D.N. , Gottlieb G.S. , Sow P.S. , Toure M. , Sall F. , Gaye A. , N'doye I. , Kiviat N.B. , Hawes S.E. , University of Washington-Dakar HIV Study Group .
Source: AIDS (London, England), 2013-09-24; 27(15), p. 2441-50.
PMID: 23665777
Related Citations

Trends of HIV-1, HIV-2 and dual infection in women attending outpatient clinics in Senegal, 1990-2009.
Authors: Heitzinger K. , Sow P.S. , Dia Badiane N.M. , Gottlieb G.S. , N'Doye I. , Toure M. , Kiviat N.B. , Hawes S.E. , University of Washington-Dakar HIV and Cervical Cancer Study Group .
Source: International journal of STD & AIDS, 2012 Oct; 23(10), p. 710-6.
PMID: 23104745
Related Citations

HIV shedding in the oral cavity: an assessment of HIV type, immunovirologic, demographic and oral factors.
Authors: Pavlinac P.B. , Hawes S.E. , Gottlieb G.S. , Gaye A. , N'Diaye C.F. , Critchlow C.W. , Sow P.S. , Feng Q. , Kiviat N.B. .
Source: Sexually transmitted infections, 2012 Feb; 88(1), p. 45-50.
PMID: 22250179
Related Citations

Lower levels of HIV-2 than HIV-1 in the female genital tract: correlates and longitudinal assessment of viral shedding.
Authors: Hawes S.E. , Sow P.S. , Stern J.E. , Critchlow C.W. , Gottlieb G.S. , Kiviat N.B. .
Source: AIDS (London, England), 2008-11-30; 22(18), p. 2517-25.
PMID: 19005275
Related Citations

Factors associated with CD4 lymphocyte counts in HIV-negative Senegalese individuals.
Authors: Mair C. , Hawes S.E. , Agne H.D. , Sow P.S. , N'doye I. , Manhart L.E. , Fu P.L. , Gottlieb G.S. , Kiviat N.B. .
Source: Clinical and experimental immunology, 2008 Mar; 151(3), p. 432-40.
EPub date: 2008-01-10.
PMID: 18190600
Related Citations

The impact of HIV status and type on the clearance of human papillomavirus infection among Senegalese women.
Authors: Rowhani-Rahbar A. , Hawes S.E. , Sow P.S. , Toure P. , Feng Q. , Dem A. , Dembele B. , Critchlow C.W. , N'Doye I. , Kiviat N.B. .
Source: The Journal of infectious diseases, 2007-09-15; 196(6), p. 887-94.
EPub date: 2007-08-07.
PMID: 17703420
Related Citations

Incident high-grade squamous intraepithelial lesions in Senegalese women with and without human immunodeficiency virus type 1 (HIV-1) and HIV-2.
Authors: Hawes S.E. , Critchlow C.W. , Sow P.S. , Touré P. , N'Doye I. , Diop A. , Kuypers J.M. , Kasse A.A. , Kiviat N.B. .
Source: Journal of the National Cancer Institute, 2006-01-18; 98(2), p. 100-9.
PMID: 16418512
Related Citations

Increased risk of high-grade cervical squamous intraepithelial lesions and invasive cervical cancer among African women with human immunodeficiency virus type 1 and 2 infections.
Authors: Hawes S.E. , Critchlow C.W. , Faye Niang M.A. , Diouf M.B. , Diop A. , Touré P. , Aziz Kasse A. , Dembele B. , Salif Sow P. , Coll-Seck A.M. , et al. .
Source: The Journal of infectious diseases, 2003-08-15; 188(4), p. 555-63.
EPub date: 2003-07-23.
PMID: 12898443
Related Citations

Prevalence of specific types of human papillomavirus and cervical squamous intraepithelial lesions in consecutive, previously unscreened, West-African women over 35 years of age.
Authors: Xi L.F. , Touré P. , Critchlow C.W. , Hawes S.E. , Dembele B. , Sow P.S. , Kiviat N.B. .
Source: International journal of cancer, 2003-03-01; 103(6), p. 803-9.
PMID: 12516102
Related Citations

Single-nucleotide polymorphisms and haplotype analysis in beta-defensin genes in different ethnic populations.
Authors: Jurevic R.J. , Chrisman P. , Mancl L. , Livingston R. , Dale B.A. .
Source: Genetic testing, 2002 Winter; 6(4), p. 261-9.
PMID: 12537649
Related Citations

Equal plasma viral loads predict a similar rate of CD4+ T cell decline in human immunodeficiency virus (HIV) type 1- and HIV-2-infected individuals from Senegal, West Africa.
Authors: Gottlieb G.S. , Sow P.S. , Hawes S.E. , Ndoye I. , Redman M. , Coll-Seck A.M. , Faye-Niang M.A. , Diop A. , Kuypers J.M. , Critchlow C.W. , et al. .
Source: The Journal of infectious diseases, 2002-04-01; 185(7), p. 905-14.
EPub date: 2002-03-19.
PMID: 11920314
Related Citations

HLA class II DR-DQ and increased risk of cervical cancer among Senegalese women.
Authors: Lin P. , Koutsky L.A. , Critchlow C.W. , Apple R.J. , Hawes S.E. , Hughes J.P. , Touré P. , Dembele A. , Kiviat N.B. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2001 Oct; 10(10), p. 1037-45.
PMID: 11588129
Related Citations

Secretor polymorphism and human immunodeficiency virus infection in Senegalese women.
Authors: Ali S. , Niang M.A. , N'doye I. , Critchlow C.W. , Hawes S.E. , Hill A.V. , Kiviat N.B. .
Source: The Journal of infectious diseases, 2000 Feb; 181(2), p. 737-9.
PMID: 10669366
Related Citations

Periodontal status of HIV-1 and HIV-2 seropositive and HIV seronegative female commercial sex workers in Senegal.
Authors: Ndiaye C.F. , Critchlow C.W. , Leggott P.J. , Kiviat N.B. , Ndoye I. , Robertson P.B. , Georgas K.N. .
Source: Journal of periodontology, 1997 Sep; 68(9), p. 827-31.
PMID: 9379325
Related Citations

Detection of human immunodeficiency virus type 1 and type 2 in the female genital tract: implications for the understanding of virus transmission.
Authors: Critchlow C.W. , Kiviat N.B. .
Source: Obstetrical & gynecological survey, 1997 May; 52(5), p. 315-24.
PMID: 9140133
Related Citations

HIV-1, HIV-2, human papillomavirus infection and cervical neoplasia in high-risk African women.
Authors: Langley C.L. , Benga-De E. , Critchlow C.W. , Ndoye I. , Mbengue-Ly M.D. , Kuypers J. , Woto-Gaye G. , Mboup S. , Bergeron C. , Holmes K.K. , et al. .
Source: AIDS (London, England), 1996 Apr; 10(4), p. 413-7.
PMID: 8728046
Related Citations