OBJECTIVE: To determine the effect of cryotherapy on HIV-1 cervical shedding. DESIGN: Prospective cohort study. METHODS: Five hundred HIV-positive women enrolled at an HIV treatment clinic in Nairobi, Kenya were screened for cervical cancer. Women diagnosed with cervical intraepithelial neoplasia stage 2 or 3 (CIN 2/3) by histology were offered cryotherapy treatment. The first 50 women had cervical swabs taken at baseline and at 2 and 4 weeks following treatment. Swabs were analyzed for HIV-1 RNA and compared using General Estimating Equation (GEE) with binomial or Gaussian links. RESULTS: Of the 50 women enrolled, 40 were receiving antiretroviral therapy (ART) and 10 were not receiving ART at the time of cryotherapy and during study follow-up. Among all women, the odds of detectable cervical HIV-1 RNA did not increase at 2 weeks [odds ratio (OR) 1.18; 95% confidence interval (CI) 0.65-2.13] or 4 weeks (OR 1.29; 95% CI 0.71-2.33) following cryotherapy. Among 10 women not receiving ART, the OR of detectable shedding at 2 weeks was higher, but not statistically significant (OR 4.02; 95% CI 0.53-30.79; P = 0.2), and at 4 weeks remained unchanged (OR 1.00; 95% CI 0.27-3.74). CONCLUSION: There was no increase in detectable cervical HIV-1 RNA among HIV-positive women after cryotherapy. The risk of HIV-1 transmission after cryotherapy may not be significant, particularly among women already on ART at the time of cervical treatment. However, further investigation is needed among women not receiving ART.
OBJECTIVE: To determine the effect of cryotherapy on HIV-1 cervical shedding. DESIGN: Prospective cohort study. METHODS: Five hundred HIV-positive women enrolled at an HIV treatment clinic in Nairobi, Kenya were screened for cervical cancer. Women diagnosed with cervical intraepithelial neoplasia stage 2 or 3 (CIN 2/3) by histology were offered cryotherapy treatment. The first 50 women had cervical swabs taken at baseline and at 2 and 4 weeks following treatment. Swabs were analyzed for HIV-1 RNA and compared using General Estimating Equation (GEE) with binomial or Gaussian links. RESULTS: Of the 50 women enrolled, 40 were receiving antiretroviral therapy (ART) and 10 were not receiving ART at the time of cryotherapy and during study follow-up. Among all women, the odds of detectable cervical HIV-1 RNA did not increase at 2 weeks [odds ratio (OR) 1.18; 95% confidence interval (CI) 0.65-2.13] or 4 weeks (OR 1.29; 95% CI 0.71-2.33) following cryotherapy. Among 10 women not receiving ART, the OR of detectable shedding at 2 weeks was higher, but not statistically significant (OR 4.02; 95% CI 0.53-30.79; P = 0.2), and at 4 weeks remained unchanged (OR 1.00; 95% CI 0.27-3.74). CONCLUSION: There was no increase in detectable cervical HIV-1 RNA among HIV-positive women after cryotherapy. The risk of HIV-1 transmission after cryotherapy may not be significant, particularly among women already on ART at the time of cervical treatment. However, further investigation is needed among women not receiving ART.
Authors: Susan M Graham; Sarah E Holte; Norbert M Peshu; Barbra A Richardson; Dana D Panteleeff; Walter G Jaoko; Jeckoniah O Ndinya-Achola; Kishorchandra N Mandaliya; Julie M Overbaugh; R Scott McClelland Journal: AIDS Date: 2007-02-19 Impact factor: 4.177
Authors: Ruth W Gitau; Susan M Graham; Linnet N Masese; Julie Overbaugh; Vrasha Chohan; Norbert Peshu; Barbra A Richardson; Walter Jaoko; Jeckoniah O Ndinya-Achola; R Scott McClelland Journal: AIDS Date: 2010-11-13 Impact factor: 4.177
Authors: T C Wright; S Subbarao; T V Ellerbrock; J L Lennox; T Evans-Strickfaden; D G Smith; C E Hart Journal: Am J Obstet Gynecol Date: 2001-02 Impact factor: 8.661
Authors: Lynette Denny; Louise Kuhn; Michelle De Souza; Amy E Pollack; William Dupree; Thomas C Wright Journal: JAMA Date: 2005-11-02 Impact factor: 56.272
Authors: J Kreiss; D M Willerford; M Hensel; W Emonyi; F Plummer; J Ndinya-Achola; P L Roberts; J Hoskyn; S Hillier; N Kiviat Journal: J Infect Dis Date: 1994-12 Impact factor: 5.226
Authors: Richard A Zuckerman; Aldo Lucchetti; William L H Whittington; Jorge Sanchez; Robert W Coombs; Rosario Zuñiga; Amalia S Magaret; Anna Wald; Lawrence Corey; Connie Celum Journal: J Infect Dis Date: 2007-10-31 Impact factor: 5.226
Authors: E M Connor; R S Sperling; R Gelber; P Kiselev; G Scott; M J O'Sullivan; R VanDyke; M Bey; W Shearer; R L Jacobson Journal: N Engl J Med Date: 1994-11-03 Impact factor: 91.245
Authors: Sharon A Greene; Christine J McGrath; Dara A Lehman; Kara G Marson; T Tony Trinh; Nelly Yatich; Evans Nyongesa-Malava; Catherine Kiptinness; Barbra A Richardson; Grace C John-Stewart; Hugo De Vuyst; Samah R Sakr; Nelly R Mugo; Michael H Chung Journal: Clin Infect Dis Date: 2018-05-17 Impact factor: 9.079
Authors: Sharon A Greene; Hugo De Vuyst; Grace C John-Stewart; Barbra A Richardson; Christine J McGrath; Kara G Marson; T Tony Trinh; Nelly Yatich; Catherine Kiptinness; Anthony Cagle; Evans Nyongesa-Malava; Samah R Sakr; Nelly R Mugo; Michael H Chung Journal: JAMA Date: 2019-10-22 Impact factor: 56.272
Authors: Hugo De Vuyst; Michael H Chung; Iacopo Baussano; Nelly R Mugo; Vanessa Tenet; Folkert J van Kemenade; Farzana S Rana; Samah R Sakr; Chris J L M Meijer; Peter J F Snijders; Silvia Franceschi Journal: Int J Cancer Date: 2013-03-16 Impact factor: 7.396
Authors: Victoria G Woo; Teri Liegler; Craig R Cohen; George F Sawaya; Karen Smith-McCune; Elizabeth A Bukusi; Megan J Huchko Journal: AIDS Res Hum Retroviruses Date: 2013-05-15 Impact factor: 2.205
Authors: Megan J Huchko; Jennifer Sneden; George Sawaya; Karen Smith-McCune; May Maloba; Naila Abdulrahim; Elizabeth A Bukusi; Craig R Cohen Journal: Int J Cancer Date: 2014-06-10 Impact factor: 7.396
Authors: M J Huchko; V G Woo; T Liegler; H Leslie; K Smith-McCune; G F Sawaya; E A Bukusi; C R Cohen Journal: BJOG Date: 2013-05-07 Impact factor: 6.531
Authors: H De Vuyst; N R Mugo; M H Chung; K P McKenzie; E Nyongesa-Malava; V Tenet; J W Njoroge; S R Sakr; Cjl M Meijer; P J F Snijders; F S Rana; S Franceschi Journal: Br J Cancer Date: 2012-10-02 Impact factor: 7.640