Increased CD4+ T cell count is associated with lower anal human papillomavirus prevalence among HIV-positive male cohort in Taizhou, China: a cross-sectional study

Jing Zhang; Xiaoxiao Chen; Yiwen Ye; Weiwei Shen; Xiaohong Ye; Yajun Lin; Zhebin Lin; Shigang Tan; Meiyang Gao; Yingying Ding; Haijiang Lin; Youyi Wang; Na He; Xing Liu

doi:10.1186/s12879-022-07251-3

Increased CD4⁺ T cell count is associated with lower anal human papillomavirus prevalence among HIV-positive male cohort in Taizhou, China: a cross-sectional study

BMC Infect Dis. 2022 Mar 14;22(1):250. doi: 10.1186/s12879-022-07251-3.

Authors

Jing Zhang^#¹, Xiaoxiao Chen^#², Yiwen Ye¹, Weiwei Shen², Xiaohong Ye³, Yajun Lin⁴, Zhebin Lin⁵, Shigang Tan⁶, Meiyang Gao¹, Yingying Ding¹, Haijiang Lin², Youyi Wang¹, Na He¹, Xing Liu⁷

Affiliations

¹ Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
² Taizhou City Center for Disease Control and Prevention, Taizhou, Zhejiang, China.
³ Linhai District Center for Disease Control and Prevention, Taizhou, Zhejiang, China.
⁴ Sanmen District Center for Disease Control and Prevention, Taizhou, Zhejiang, China.
⁵ Wenling District Center for Disease Control and Prevention, Taizhou, Zhejiang, China.
⁶ Huangyan District Center for Disease Control and Prevention, Taizhou, Zhejiang, China.
⁷ Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China. liuxing@fudan.edu.cn.

^# Contributed equally.

Abstract

Objectives: This study aims to investigate the association between CD4⁺ T cell count and combined antiretroviral therapy (cART) with the prevalence of anal human papillomavirus (HPV) infection among HIV-positive male cohort in China.

Methods: A survey was conducted in men from a HIV cohort in Taizhou, China between 2016 and 2019. A face-to-face questionnaire interview was administered, and an anal-canal swab was collected for HPV genotyping.

Results: A total of 766 HIV-positive men were recruited. The HPV prevalence was lower among those with increased CD4⁺ T cell count than those with decreased or unchanged (46.5 vs. 56.6%, p = 0.033) from baseline. In multivariable models, having the current CD4⁺ T cell count of 350-499 cells/µL (aOR 0.28, 95% CI 0.13-0.64), and of ≥ 500 cells/µL (aOR 0.26, 95% CI 0.11-0.60) were associated with lower prevalence of any type HPV infection compared with those with < 200 cells/µL. Having taken NVP + 3TC + AZT was inversely associated with any high-risk (HR)-HPV (aOR 0.47, 95% CI 0.25-0.90) and any low-risk (LR)-HPV infection (aOR 0.40, 95% CI 0.18-0.88), compared with those taking EFV + 3TC + TDF.

Conclusions: Increased CD4⁺ T cell count at follow-up was significantly associated with lower prevalence of anal HPV infection. Inverse associations between NVP + 3TC + AZT and HR-HPV or LR-HPV infecton were observed.

Keywords: Anal HPV infection; Antiretroviral therapy; CD4; HIV/AIDS; Male.

MeSH terms

Alphapapillomavirus*
CD4-Positive T-Lymphocytes
China / epidemiology
Cross-Sectional Studies
HIV Infections* / complications
HIV Infections* / epidemiology
Humans
Lymphocyte Count
Male
Papillomaviridae / genetics
Prevalence
Risk Factors