HPV and HIV Co-Infection: Clinical, Socio-Behavioral, and Microbiome Implications

项目摘要 目前迫切需要更好地了解口腔人乳头瘤病毒（HPV）的流行病学和生物学 艾滋病病毒感染者（PLWH）。这反过来将有助于确定导致HPV的病理生理学- 相关表现如口腔和肛门疣以及口咽鳞状细胞癌。这是 一项旨在帮助解决这一需求的探索性横断面前瞻性队列研究。这个目标 根据国家牙科和颅面研究所（NIDCR）的使命， 有助于预测、预防和最终治疗PLWH中HPV感染及其后遗症的标志物， 潜在的生物、临床和社会行为因素。口腔和肛门拭子将从HPV+和 HPV-PLWH以评估两组中的微生物组。免疫状态（CD 4计数和病毒载量）和 将在两组中比较抗逆转录病毒治疗（ART）方案以及与微生物组的关系。临床 结果（口腔和肛门病变，患病，缺失，补牙）和社会行为因素（性行为， 烟草/酒精暴露）也将在HPV+和HPV- PLWH中进行比较。核心假设是， HPV与HIV的共感染将与一定程度的口腔和肛门微生物组生态失调、失调、 免疫状态和特定的社会行为因素。具体目标1：阐明富集途径， 了解PLWH的口腔和肛门微生物组生态失调。具体目标2：检查免疫状态以及 ART方案在PLWH中的HPV感染。具体目标3：描述临床和社会- 行为方面增加了PLWH中HPV感染的风险。拟议的研究应确定相关因素 这些变量提供了对HIV/HPV合并感染的深入了解。未来的研究计划将包括一个前景 纵向研究，以监测该PLWH队列中HPV持续性和癌症发展。

Project Summary Abstract There is a critical need to better understand the epidemiology and biology of oral human papillomavirus (HPV) infection in people living with HIV (PLWH). This will, in turn, help identify the pathophysiology leading to HPV- related manifestations such as oral and anal warts as well as oropharyngeal squamous cell carcinoma. This is an exploratory cross-sectional prospective cohort study designed to help address this need. The goal of this study, in line with the mission of the National Institute of Dental and Craniofacial Research (NIDCR), is to identify markers that will help predict, prevent, and ultimately treat HPV infection and its sequelae in PLWH based on underlying biologic, clinical, and socio-behavioral factors. Oral and anal swabs will be obtained from HPV+ and HPV- PLWH to evaluate the microbiome in the two groups. Immune status (CD4 count and viral load) and antiretroviral therapy (ART) regimen will be compared in the two groups and in relation to the microbiome. Clinical findings (oral and anal lesions, diseased, missing, filled teeth) and socio-behavioral factors (sexual practices, tobacco/alcohol exposure) will also be compared in HPV+ and HPV- PLWH. The central hypothesis is that oral HPV co-infection with HIV will correlate with a certain degree of oral and anal microbiome dysbiosis, dysregulated immune status and specific socio-behavioral factors. Specific Aim 1: Elucidate enrichment pathways to further understand oral and anal microbiome dysbiosis in PLWH. Specific Aim 2: Examine immune status as well as ART regimen in PLWH with respect to HPV infection. Specific Aim 3: Characterize the clinical and socio- behavioral aspects that increase risk of HPV infection in PLWH. The proposed study should identify correlates of variables that offer insight into HIV/HPV co-infection. Future research plans will include a prospective longitudinal study to monitor for HPV persistence and the development of cancer in this cohort of PLWH.