OBJECTIVES: To evaluate the prevalence and the risk factors for cervical intraepithelial neoplasia (CIN) among HIV-infected women. METHODS: Cross-sectional study of 494 HIV-infected women in Brazil, between 1998 and 2008. Gynecologic exam was performed, and samples were collected for cervical cytology and for HPV DNA detection. Cervical biopsy was carried out when indicated. HPV infection, CD4 T-lymphocyte count and HIV viral load were compared with cervical histopathology. Univariate and multivariate statistical analyses were performed to evaluate the statistical association of several risk factors. RESULTS: CIN prevalence detected by histopathology was 23.4% (6% of CIN2/3 and 17.4% cases of CIN1). Multivariate analysis confirmed an independent association of CIN with CD4 T-lymphocyte count below 200 cells/mm³ (OR 5.0, 95% CI 2.5-10.1), with a positive detection of HPV DNA (OR 2.0, 95% CI 1.2-3.5), and with age < 34 years old (OR 1.5, 95% CI 1.0-2.4). HIV viral load and antiretroviral use were not independent risk factors for CIN. CONCLUSIONS: Severity of immunosuppression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infected women.
OBJECTIVES: To evaluate the prevalence and the risk factors for cervical intraepithelial neoplasia (CIN) among HIV-infectedwomen. METHODS: Cross-sectional study of 494 HIV-infectedwomen in Brazil, between 1998 and 2008. Gynecologic exam was performed, and samples were collected for cervical cytology and for HPV DNA detection. Cervical biopsy was carried out when indicated. HPV infection, CD4 T-lymphocyte count and HIV viral load were compared with cervical histopathology. Univariate and multivariate statistical analyses were performed to evaluate the statistical association of several risk factors. RESULTS:CIN prevalence detected by histopathology was 23.4% (6% of CIN2/3 and 17.4% cases of CIN1). Multivariate analysis confirmed an independent association of CIN with CD4 T-lymphocyte count below 200 cells/mm³ (OR 5.0, 95% CI 2.5-10.1), with a positive detection of HPV DNA (OR 2.0, 95% CI 1.2-3.5), and with age < 34 years old (OR 1.5, 95% CI 1.0-2.4). HIV viral load and antiretroviral use were not independent risk factors for CIN. CONCLUSIONS: Severity of immunosuppression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infectedwomen.
Authors: Theodora M Zohoncon; Cyrille Bisseye; Florencia W Djigma; Albert T Yonli; Tegwinde R Compaore; Tani Sagna; Djeneba Ouermi; Charlemagne M R Ouédraogo; Virginio Pietra; Jean-Baptiste Nikiéma; Simon A Akpona; Jacques Simpore Journal: Mediterr J Hematol Infect Dis Date: 2013-09-02 Impact factor: 2.576
Authors: Milena Camargo; Sara C Soto-De Leon; Marina Munoz; Ricardo Sanchez; Diego Peña-Herrera; Andrea Clemencia Pineda-Peña; Otto Sussmann; Carol Paez; Antonio Perez-Prados; Manuel Elkin Patarroyo; Manuel Alfonso Patarroyo Journal: BMC Cancer Date: 2014-06-18 Impact factor: 4.430