Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
In Reply: Our conclusion that recent sexual
intercourse with a new partner provides a significant risk for the aquisition
of HPV was strongly supported by a relative hazard of 10.1 per new partner
per month. If most of these positive results were due to upregulated latent
infections, as Ms Buchanan and Dr Nieland-Fisher suggest, then having sex
with a new partner must have resulted in this upregulation. We are not aware
of any studies supporting this hypothesis. As Buchanan and Nieland-Fisher
point out, new sexual partners did not influence the presence or absence of
HPV in HIV-infected women in our previous study, suggesting that the immune
regulation of young HIV-infected women is related to control of HPV. Although
we did not report this in our article, we initiated HIV screening in the cohort
in 1995 and found no positive results. Furthermore, anonymous HIV screening
performed at both clinics yielded seropositivity rates of less than 1%, making
us confident that none of our study subjects were infected with HIV. We also
queried subjects at each visit about immunosuppression-related illnesses.
The occurrence of such illnesses in the group was almost nonexistent (n =
1). It is true that distinguishing recurrences from new infection is difficult,
but unless having sex with a new partner stimulates a latent infection, we
are not aware of any alternative explanation for our finding.
Moscicki A, Hills NK, Darragh T, Shiboski S. Role of Immune Function in Human Papillomavirus Infection—Reply. JAMA. 2001;286(10):1173–1174. doi:10.1001/jama.286.10.1173
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