Human Papillomavirus Types Associated with Cervical Dysplasia among HIV‐ and Non‐HIV‐Infected Women Attending Reproductive Health Clinics in Eastern Kenya

Njue, James Kinoti; Muturi, Margaret; Kamau, Luna; Lwembe, Raphael

doi:10.1155/2021/2250690

Cited by 4 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We followed the methods described in our previous research publication [ 14 ] that focused on HPV types detected among HIV-infected and noninfected women in the same study region.…”

Section: Methodsmentioning

confidence: 99%

“…We followed the methods described in our previous research publication [14] that focused on HPV types detected among HIV-infected and noninfected women in the same study region. This was a comparative cross-sectional study carried out in Meru, Embu, Kirinyaga, Isiolo, and Chuka Referral Hos-pital's Reproductive Health Clinics and HIV Voluntary Cancelling and Testing (HIV-VCT) Centers from January 2018 to December 2019.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Primary and Triage Cervical Screening Diagnostic Value of Methods for the Detection of Cervical Dysplasia

Njue

Muturi

Kamau

et al. 2022

BioMed Research International

Self Cite

View full text Add to dashboard Cite

Background Cervical cancer is a leading cause of mortality among women globally. Approaches to reduce cervical cancer incidence and mortality are “screen-and-treat,” where positive primary test only is used in the treatment and “screen, triage and treat,” where treatment is based on positive primary and triage tests with/without histological analysis. Objectives To determine cervical screening outcomes among HIV-infected and noninfected women using VIA, Pap smear, and HPV-PCR cervical screening methods and to determine the sensitivity, specificity, PPV and NPV of VIA, Pap smear, and HPV-PCR as primary test and sequential triage based on abnormal histopathology among HIV-infected and noninfected women. Methodology . This was a comparative cross-sectional study where women aged 18-46 years women underwent cervical screening and colposcopy-biopsy test as a positive-confirmatory test in the Referral Hospitals of Eastern Kenya. Results A total of 317 (HIV negative: 156/317 (49.2%) and HIV positive: 161/317 (50.8%)) women were enrolled. Of these 81/317 (25.6%), 84/317 (26.5%), 96/317 (30.2%), and 78/122 (63.9%) participants had VIA, HPV DNA-PCR, Pap smear, and cervical histology positive results, respectively; average: 27.4% (HIV positive: 21.5%; HIV negative: 5.9%). Majority of women with LSIL [17/317 (5.4%)], HSIL [22/317 (6.9%)], invasive cancer [5/317 (1.6%)], cervicitis [45/317 (14.2%], and candidiasis 47/317 (14.8%) were HIV-infected ( p < 0.001). 78/317 (24.6%) participants had positive histology test [ASCUS: 34/317 (10.7%) CIN1:17/317 (5.3%), CIN2: 16/317 (5.0%), CIN3:6/317 (1.9%), and ICC: 5/317 (1.6%)] ( p > 0.001). A higher primary diagnostic accuracy was established by HPV DNA-PCR (sensitivity: 95.5%; specificity: 92.6%) than Pap smear and VIA test while in triage testing, high sensitivity was obtained by HPV DNA-PCR parallel testing with VIA test (92.6%) and Pap smear test (92.7%) and VIA cotesting with Pap smear (99.9%). HIV-infected women had increased specificity and reduced sensitivity and diagnostic accuracy by both primary and triage testing approaches. Discussion . Abnormal cervical screening outcome was high among HIV-infected than noninfected women. HIV-infected women had significantly high cases of cervical neoplastic changes. The diagnostic value of primary tests increased upon concurrent testing with other test methods hence reducing the number of women who would have been referred for biopsy. Conclusion High sensitivity and specificity in detection of CIN+ were established among HIV-infected than HIV noninfected women by HPV DNA-PCR and Pap smear than VIA test. HPV DNA-PCR test and Pap smear are more accurate in primary and sequential triage cervical screening based on abnormal histopathology outcomes among HIV-infected than noninfected women.

show abstract

“…We followed the methods described in our previous research publication [ 14 ] that focused on HPV types detected among HIV-infected and noninfected women in the same study region.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Primary and Triage Cervical Screening Diagnostic Value of Methods for the Detection of Cervical Dysplasia

Njue

Muturi

Kamau

et al. 2022

BioMed Research International

Self Cite

View full text Add to dashboard Cite

show abstract

“…HPV infects undifferentiated deeper layers basal epithelial cells with mitotic capacity by which HPV maintains cell division and guarantee its multiplication and persistence 125 and epithelial transition zones susceptible to carcinogenesis 128 . There are a lot of risk factors already known for HPV infection such as: early sex debut, multiple sexual partners, long-term inflammation caused by recurrent genital infections, long-term use of hormonal contraceptives, hormonal changes during pregnancy, cervical trauma during labor, failure to undergo HPV vaccination, HIV infection and not being circumcised 124,129 . HPV could be classified by its oncogenic potential in high-risk (HRHPV), probably high-risk and low-risk (LRHPV) 124,125,127,130 .…”

Section: Hpvmentioning

confidence: 99%

“…Warts are usually asymptomatic flat, papular or pedunculated growths on the mucosa or epithelium but can cause pain, itching or dyspareunia 132 . There are many risk factors to progression to highgrade lesions and cancer: persistence of HPV infection, infection with oncogenic types, age over 30 years, infection with multiple HPV types, human immunodeficiency virus (HIV) infection, long-term exposure to hormonal contraceptives, immunosuppression, and tobacco use 127,129 . Treatment is directed for the HPV-lesion or HPV-related cancer 132 .…”

Section: Hpvmentioning

confidence: 99%

“…Treatment is directed for the HPV-lesion or HPV-related cancer 132 . Global annual mortality related to HPV is 8.2% 129 and morbidity is still high related to many regions of the world having scarce resources, vaccination coverage being unavailable or incomplete and nonexistence or unfollowed screening programs 125 . HIV was shown to influence the natural history of HPV types 133 and has been associated as a major cofactor with HPV to induce cervical cancer, as HIV-patients are at a higher risk of persistent HPV infection 126 , through the direct effect of HIV and immunosuppression caused by active HIV infection 128 .…”

Section: Hpvmentioning

confidence: 99%

See 1 more Smart Citation

Opportunistic Infections in the Immunocompromised: Hiv Vs Non-HIV Patients - A Narrative Review

Figueiredo

Martins

Midões

et al. 2022

MRAJ

View full text Add to dashboard Cite

Opportunistic infections affect patients with immunocompromised status and are caused by common microorganisms with more severe presentations, or atypical organisms that do not cause disease in the immunocompetent. The type of infection varies with the type of immune dysfunction. Patients with cell-mediated immune dysfunction tend to be infected with a range of viral infections, intracellular bacteria, and fungi. This contrasts to patients with defects in humoral immunity, where infections with encapsulated bacteria, and enteric organisms such Giardia lamblia and enteroviruses predominate. Patients with phagocytic defects are especially prone to infections with Gram-negative bacteria and fungi, whilst those with complement disorders are prone to recurrent infections with encapsulated bacteria. In contrast to patients with primary immunodeficiencies, which usually present with only one defect of the above, acquired immunodeficiencies present with a variety of those, and clinical presentations are diversified. The epidemic of HIV and AIDS shed some light into infections that were before extremely rare, by making them frequent, but with the advent of anti-retroviral therapy their clinical presentation has shifted. Also, the emergence of novel immunotherapies for cancer and autoimmune diseases, allied with an increase in organ transplant has increased the pool of immunosuppressed patients without HIV, which present differently regarding opportunist infections. Rapid and specific microbiologic diagnosis is essential. Newer microbiologic assays have improved the diagnosis and management of opportunistic infections. Our aim was to revise and summarize the most frequent opportunist infections, and how their presentation and course compares in different immunosuppressed diseases (HIV and non-HIV).

show abstract

The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis

Moyo-Chilufya,

Maluleke,

Kgarosi

et al. 2023

eClinicalMedicine

View full text Add to dashboard Cite

Human Papillomavirus Types Associated with Cervical Dysplasia among HIV‐ and Non‐HIV‐Infected Women Attending Reproductive Health Clinics in Eastern Kenya

Cited by 4 publications

References 22 publications

Primary and Triage Cervical Screening Diagnostic Value of Methods for the Detection of Cervical Dysplasia

Primary and Triage Cervical Screening Diagnostic Value of Methods for the Detection of Cervical Dysplasia

Opportunistic Infections in the Immunocompromised: Hiv Vs Non-HIV Patients - A Narrative Review

The burden of non-communicable diseases among people living with HIV in Sub-Saharan Africa: a systematic review and meta-analysis

Contact Info

Product

Resources

About