Dissecting the influence of HIV infection and treatment with antiretroviral therapy on Human Papillomavirus infection, disease and immunity: Designing new tools for therapeutic intervention.

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The increase of HPV infection associated cervical lesions and accelerated carcinogenesis in HIV+ women of antiretroviral therapy (ART) implies that HIV-induced dysregulation of the HPV-specific immune response increases HR HPV replication, reduces HPV clearance and consequently increases the risk of progression to mild and moderate dysplasia even in the presence of ART. We postulate that higher HR HPV loads in HIV+ women in the presence of moderate cervical dysplasia facilitate statistically more frequent HPV DNA integration events into the host genome. We hypothesize that HPV viral integration is the key event in driving rapid cancerogenesis in HIV+ women. A therapeutic HPV vaccine might be able to resurrect HPV-specific adaptive immunity to erradicate persistent HPV infection and hence prevent HPV disease progression in HIV+ individuals on ART. The 2H study aims to elucidate the complicated interplay between HIV, the immune system and HPV induced carcinogenesis in the era of ART.