The introduction of highly active antiretroviral therapy (HAART) has transformed HIV from a progressive fatal disease into a chronic condition. As a result, perinatally infected children in Asia are now reaching adolescence. A period frequently associated with the search for independence and risk-taking behaviors, adolescence is accompanied by elevated risk for sexually transmitted infections such as human papillomavirus (HPV), which is the primary cause of cervical and anal cancer.
Adolescent girls cross a street in Bangkok, Thailand. Photo: Kevin Tachman
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Adolescents with HIV may be at greater risk for HPV infection, disease persistence, and for developing HPV-related complications because of the impact of the virus on their immune systems. Pilot data from a small TREAT Asia-funded study of 16 sexually active, perinatally HIV-infected adolescent females (at a median age of 16 years) in Bangkok, Thailand, showed that half were already infected with HPV. Unfortunately, there are no available data on HPV in perinatally HIV-infected males in Asia.
With a new five-year research grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the U.S. National Institutes of Health (NIH/NICHD), TREAT Asia network researchers will begin studying the natural history of HPV infection among female and male adolescents in Thailand and Vietnam, with the goal of identifying opportunities to reduce the risk of early HPV infection and informing future HPV vaccination strategies in Asia.
In partnership with the Thai Red Cross AIDS Research Centre, TREAT Asia will collaborate with HIV-NAT and Siriraj Hospital, Mahidol University, in Bangkok; Chiangrai Prachanukroh Hospital in northern Thailand; and Children’s Hospital 1 and Hung Vuong Obstetrics and Gynecology Hospital in Ho Chi Minh City, Vietnam. The study seeks to enroll perinatally HIV-infected and uninfected adolescents, and monitor their health and risk factors for HPV infection and pre-cancers of the cervix over the course of three years.
“The fact that perinatally HIV-infected children are now surviving into adolescence and young adulthood is a great achievement, but it raises new questions about what is necessary to allow these youth to live full and productive lives,” said Dr. Rohan Hazra, of the Maternal and Pediatric Infectious Disease Branch of NIH/NICHD. “We are very excited about work such as this that is starting to address some of the challenges these youth now face.”
By building on TREAT Asia’s existing regional pediatric HIV research network and utilizing expertise gained through previous studies of HPV infection in adults, this study will enhance the region’s scientific capacity for assessing the long-term impact of HIV infection on adolescents in Asia.