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Author Notes:

Corresponding author and reprints: Ighovwerha Ofotokun, MD, MSc., Associate Professor of Medicine, Division of Infectious Diseases, Emory University School of Medicine, 49 Jesse Hill Jr Dr SE, Atlanta, GA 30303., Phone: 404-616-0659, Fax: 404-616-0592, iofotok@emory.edu.

The two senior authors contributed equally to this work.

K. Anastos receives consultant fees from Bristol Myers Squibb, Miriam Hospital of Providence, RI; L.S Massad receives consulting fees from the Chicago WIHS and from the ACCDON for manuscript editing; G. D’Souza received grant funding from Merck &Co; J.M Palefsky receives consultancy fees from Quiagen, has board membership at Merck & Co, owns stock options from Aura Biosciences, has received travel and meeting funds from Merck & Co, and has grants pending from Merck & Co and Hologic; H.D Strickler collaborates with MTM/Roche, BD, and Arbor Vita on studies of molecular methods for cervical cancer detection; I. Ofotokun receives grant funding from Bristol Myers Squibb.

All other authors had no conflicts of interest to report.

Subjects:

Research Funding:

Supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under the Award Number UL1TR000454 and KL2TR000455.

For a complete list of sources of funding, please see the full article.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • HUMAN-IMMUNODEFICIENCY-VIRUS
  • ACTIVE ANTIRETROVIRAL THERAPY
  • SEROPOSITIVE WOMEN
  • CERVICAL LESIONS
  • NATURAL-HISTORY
  • GENITAL-TRACT
  • RISK
  • REGRESSION
  • CANCER
  • HPV

Oral Lopinavir Use and Human Papillomavirus Infection in HIV-Positive Women

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Journal Title:

Journal of Acquired Immune Deficiency Syndromes

Volume:

Volume 70, Number 2

Publisher:

, Pages E63-E66

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Invasive cervical cancer (ICC) is the third most common female malignancy and fourth most common cause of cancer death in women globally. The risk of ICC is several-fold higher in HIV-positive women than in HIV-negative women, as are the prevalence, incidence, and persistence of oncogenic human papillomavirus (oncHPV), the infectious cause of most ICC. Although use of effective highly-active antiretroviral therapy (HAART) has been associated with reduced oncHPV prevalence and incidence and increased regression of cervical lesions, the overall incidence of ICC has not decreased in HIV-positive women during the HAART era. By increasing survival, HAART may increase lifetime oncHPV infections, allowing accumulation of somatic mutations and epigenetic changes necessary for oncogenesis. Currently, no anti-viral medications are clinically approved to treat cervical HPV infections. In vitro studies have shown that lopinavir (LPV), an HIV-1 protease inhibitor (PI) used in some HAART regimens, may have activity against oncHPV through inhibition of viral oncogene E6. Most recently, an early phase clinical trial conducted in Nairobi, Kenya studied topical application of LPV to the cervix; preliminary results showed that 21 of 23 women initially diagnosed with high-grade disease returned to normal on subsequent Papanicolaou (Pap) smears and showed visible regression of cervical lesions. We therefore assessed the hypothesis that oral LPV use may be associated with decreased prevalence and increased clearance of oncHPV compared to other antiretroviral (ARV) regimens.

Copyright information:

© 2015, Copyright (C) 2015 Wolters Kluwer Health, Inc. All rights reserved.

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