Effect of HIV and immunosuppression on oral HPV persistence in the HAART era

描述（由申请人提供）：人乳头瘤病毒（HPV）是一种性传播感染，最近已被证明可导致一些扁桃体癌，但对口腔HPV的自然史以及影响这些感染持续发展为扁桃体癌的因素知之甚少。在美国，口咽癌（扁桃体）的发病率正在增加，其中大多数癌症是由HPV引起的。艾滋病毒感染者感染口腔HPV的几率更高，患扁桃体癌的风险也更高。初步研究表明，抗逆转录病毒疗法并不能改善口腔HPV感染的清除率。自采用HAART疗法以来，口腔疣（由HPV引起）和HPV相关癌症的患病率并未下降。提出了一项前瞻性研究，其中来自多中心艾滋病队列研究（MACS）和妇女机构间艾滋病毒研究（WIHS）的600名艾滋病毒感染者和400名未感染艾滋病毒的人将每六个月随访一次，为期四年。在每次访问中，我们将使用口腔冲洗和漱口剂从参与者的口腔中收集细胞，并对这些细胞进行37种不同类型的HPV检测。我们将评估口腔HPV感染的常见程度以及使这些感染更难清除的因素。比较HIV感染者和非HIV感染者的口腔HPV自然史将有助于我们了解HIV和相关免疫抑制对清除口腔HPV感染能力的影响。

DESCRIPTION (provided by applicant): Human papillomavirus (HPV) is a sexually transmitted infection that has recently been shown to cause some tonsillar cancers, yet little is known about oral HPV natural history and factors which influence the persistence and progression of these infections into tonsillar cancers. The incidence of oropharyngeal (tonsillar) cancer is increasing the United States and most of these cancers are caused by HPV. People with HIV have a higher rate of oral HPV infection and higher risk of tonsillar cancer. Initial studies suggest antiretroviral therapy does not improve clearance of oral HPV infection. The prevalence of both oral warts (which is caused by HPV) and HPV-associated cancers have not decreased since the introduction of HAART. A prospective study is proposed in which 600 HIV- infected and 400 HIV-uninfected people from the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV Study (WIHS) will be followed every six months for four years. At each visit we will collect cells from participants' mouths using an oral rinse and gargle and test these cells for 37 different types of HPV. We will evaluate how common oral HPV infections are and factors which make it harder to clear these infections. Comparing oral HPV natural history in people with and without HIV will help us to understand the effect that HIV and related immunosupression have on the ability to clear oral HPV infections.