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

项目摘要摘要 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。 艾滋病毒携带者(PLWH)的感染。这反过来将有助于确定导致HPV的病理生理学- 相关表现，如口腔和肛门尖锐湿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。这样做的目的是 这项研究与国家牙科和颅面研究所(NIDCR)的使命一致，是为了识别 有助于预测、预防和最终治疗人类乳头瘤病毒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检测两组患者的微生物群。免疫状态(CD4计数和病毒载量)和 抗逆转录病毒治疗(ART)方案将在两组中进行比较，并与微生物组进行比较。临床 调查结果(口腔和肛门损伤、疾病、缺失、充牙)和社会行为因素(性行为、 也将在HPV+和HPV-PLWH中进行比较。中心假设是口头的 HPV与HIV混合感染会导致一定程度的口腔和肛门微生物群失调，调节失调 免疫状态和特定的社会行为因素。具体目标1：阐明进一步丰富的途径 了解PLWH患者的口腔和肛门微生物群失调。具体目标2：检查免疫状态以及 PLWH中的ART方案与HPV感染有关。具体目标3：描述临床和社会-- 增加PLWH中HPV感染风险的行为方面。拟议的研究应确定相关因素 对艾滋病毒/人乳头瘤病毒混合感染提供洞察的变量。未来的研究计划将包括前瞻性的 在PLWH队列中监测HPV持久性和癌症发展的纵向研究。

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.