Variants of human papillomaviruses 16 and 18 and their natural history in human immunodeficiency virus-positive women

1 Albert Einstein College of Medicine, Department of Epidemiology and Population Health, 1300 Morris Park Avenue, Bronx, NY 10461, USA 2 University of California, San Francisco, San Francisco, CA, USA 3 Maimonides Medical Center, Brooklyn, NY, USA 4 Southern Illinois University School of Medicine, Springfield, IL, USA 5 The Henry M. Jackson Foundation, Rockville, MD, USA 6 University of Southern California, Los Angeles, CA, USA 7 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA 8 National Institute of Child Health and Human Development, Bethesda, MD, USA Correspondence Nicolas F. Schlecht nschlech{at}aecom.yu.edu Highly oncogenic human papillomavirus (HPV) 16 and 18 variants might be expected to be particularly aggressive in HIV-positive women. The association of HPV16 and 18 variant lineages with race, human immunodeficiency virus (HIV) coinfection, CD4 + T-cell count, HIV-RNA level, time-to-clearance of HPV infection and presence of squamous intraepithelial lesions (SIL) among women in the Women's Interagency HIV Study was studied. Subjects were followed semi-annually with Pap smear and cervicovaginal lavage (CVL). HPV DNA was detected in CVLs using MY09/11 L1 PCR assay. Specimens positive for HPV16/18 underwent E6 PCR and sequencing to determine the variant present. Specimens from 195 HPV16- and 162 HPV18-positive women were classified into variant lineages based on sequencing results. African variants of HPV16 and HPV18 were significantly more prevalent among African-Americans than among Caucasians [42 versus 14 % ( P =0·001) and 60 versus 13 % ( P