Shahana A Choudhury1, Natasha A Choudhury2, Ammie D Humphrey3, Vladimir Berthaud4, Gwinnett Ladson5, Vernita A Tucker6, Sten H Vermund7. 1. Department of Pediatrics, Meharry Medical College. Electronic address: schoudhury@mmc.edu. 2. Meharry Medical College. 3. Ob/Gyn Clinics, MMC. 4. Department of Internal Medicine, MMC. 5. Department of Obstetrics and Gynecology, Meharry Medical College. 6. Department of Obstetrics and Gynecology, MMC. 7. Vanderbilt Institute for Global Health.
Abstract
INTRODUCTION: Persistent high risk human papillomavirus (hrHPV) has been associated with cervical abnormalities and cancer. There are few studies comparing HIV-infected with uninfected African American women from the Southern U.S. We evaluated medical records of a women's cohort in an urban clinic in Tennessee to assess the prevalence of hrHPV and cytology correlates, as well as HPV vaccination rates. METHODS: We reviewed medical records of 50 HIV infected and 304 HIV uninfected women, including Pap smears and hrHPV. RESULTS: HIV-infected women were older than HIV-uninfected women (p<0.0001) and were more likely to have hrHPV (p=<0.0001) and LGSIL/HGSIL (p=0.006). Within the HIV uninfected group, Hispanic women were younger than non-Hispanic African American women (p=0.04) and non-Hispanic white women (p=0.0002). Non-Hispanic African-American women were younger (p=0.004) than non-Hispanic white women. Both HIV-uninfected and HIV-infected women had an 11-fold and 5-fold odds, respectively, of having precancerous lesions when harboring hrHPV, compared to hrHPV-uninfected women. Of the 125 HIV-uninfected women, only 17% had received at least one dose of the HPV vaccine. None of the 21 vaccine recipients had evidence of SILs compared to 9% of vaccine non-recipients (p=0.35, Fisher's exact test). CONCLUSION: HIV-infected women remained at significantly higher risk for developing cervical precancerous lesions when exposed to hrHPV than their uninfected counterparts. Hispanic women were least likely to have been vaccinated. Missed HPV vaccination trended towards being associated with a higher odds of precancerous lesions. Routine HPV vaccination should be reinforced for adolescents and young women using public hospital facilities of all races and ethnic backgrounds.
INTRODUCTION: Persistent high risk human papillomavirus (hrHPV) has been associated with cervical abnormalities and cancer. There are few studies comparing HIV-infected with uninfected African American women from the Southern U.S. We evaluated medical records of a women's cohort in an urban clinic in Tennessee to assess the prevalence of hrHPV and cytology correlates, as well as HPV vaccination rates. METHODS: We reviewed medical records of 50 HIV infected and 304 HIV uninfected women, including Pap smears and hrHPV. RESULTS:HIV-infectedwomen were older than HIV-uninfectedwomen (p<0.0001) and were more likely to have hrHPV (p=<0.0001) and LGSIL/HGSIL (p=0.006). Within the HIV uninfected group, Hispanic women were younger than non-Hispanic African American women (p=0.04) and non-Hispanic white women (p=0.0002). Non-Hispanic African-American women were younger (p=0.004) than non-Hispanic white women. Both HIV-uninfected and HIV-infectedwomen had an 11-fold and 5-fold odds, respectively, of having precancerous lesions when harboring hrHPV, compared to hrHPV-uninfected women. Of the 125 HIV-uninfectedwomen, only 17% had received at least one dose of the HPV vaccine. None of the 21 vaccine recipients had evidence of SILs compared to 9% of vaccine non-recipients (p=0.35, Fisher's exact test). CONCLUSION:HIV-infectedwomen remained at significantly higher risk for developing cervical precancerous lesions when exposed to hrHPV than their uninfected counterparts. Hispanic women were least likely to have been vaccinated. Missed HPV vaccination trended towards being associated with a higher odds of precancerous lesions. Routine HPV vaccination should be reinforced for adolescents and young women using public hospital facilities of all races and ethnic backgrounds.
Authors: Hanna Bergman; Brian S Buckley; Gemma Villanueva; Jennifer Petkovic; Chantelle Garritty; Vittoria Lutje; Alina Ximena Riveros-Balta; Nicola Low; Nicholas Henschke Journal: Cochrane Database Syst Rev Date: 2019-11-22
Authors: Manuela Viviano; Pierre DeBeaudrap; Pierre-Marie Tebeu; Jovanny T Fouogue; Pierre Vassilakos; Patrick Petignat Journal: Int J Womens Health Date: 2017-02-02