Incidence of cervical intraepithelial neoplasia in a cohort of HIV‐infected women

Araújo, Angela Cristina Labanca de; Carvalho, Nara de Oliveira; Teixeira, Nara Chartuni Pereira; Souza, Tatiana T.; Murta, Érica D.; Faria, Iwens Moreira de; Corrêa, Christine Miranda; Lima, Maria Inês Miranda; Castillo, Dora Méndez del; Melo, Victor Hugo

doi:10.1016/j.ijgo.2011.12.024

Cited by 14 publications

(12 citation statements)

References 25 publications

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“…High HPV infection prevalence in HIV-positive women has been reported in worldwide studies; there is 44% HPV infection in European countries such as Italy [5] and US studies have found 54%-73% prevalence [20,21], similar to that for Latin-American countries like Brazil where 48% to 68% HPV prevalence has been found in HIV-positive women [22,23]. …”

Section: Discussionmentioning

confidence: 85%

Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia

et al. 2014

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BackgroundHIV infection leads to a decreasing immune response, thereby facilitating the appearance of other infections, one of the most important ones being HPV. However, studies are needed for determining associations between immunodeficiency caused by HIV and/or the presence of HPV during the course of cervical lesions and their degree of malignancy. This study describes the cytological findings revealed by the Papanicolaou test, laboratory characteristics and HPV molecular profile in women with and without HIV infection.MethodsA total of 216 HIV-positive and 1,159 HIV-negative women were invited to participate in the study; PCR was used for the molecular detection of HPV in cervical samples. Statistical analysis (such as percentages, Chi-square test and Fisher’s exact test when applicable) determined human papillomavirus (HPV) infection frequency (single and multiple) and the distribution of six types of high-risk-HPV in women with and without HIV infection. Likewise, a logistic regression model was run to evaluate the relationship between HIV-HPV infection and different risk factors.ResultsAn association was found between the frequency of HPV infection and infection involving 2 or more HPV types (also known as multiple HPV infection) in HIV-positive women (69.0% and 54.2%, respectively); such frequency was greater than that found in HIV-negative women (44.3% and 22.7%, respectively). Statistically significant differences were observed between both groups (p = 0.001) regarding HPV presence (both in infection and multiple HPV infection). HPV-16 was the most prevalent type in the population being studied (p = 0.001); other viral types had variable distribution in both groups (HIV-positive and HIV-negative). HPV detection was associated with <500 cell/mm3 CD4-count (p = 0.004) and higher HIV-viral-load (p = 0.001). HPV-DNA detection, <200 cell/mm3 CD4-count (p = 0.001), and higher HIV-viral-load (p = 0.001) were associated with abnormal cytological findings.ConclusionsThe HIV-1 positive population in this study had high multiple HPV infection prevalence. The results for this population group also suggested a greater association between HPV-DNA presence and cytological findings. HPV detection, together with low CD4 count, could represent useful tools for identifying HIV-positive women at risk of developing cervical lesions.

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Section: Discussionmentioning

confidence: 85%

Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia

et al. 2014

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“…In a retrospective cohort study, Araujo et al (2012) showed HPV in 68.1% of HIV+ women, of which, 17.2% had HR-HPV, 12.9% had LR-HPV, and HR-and LR-HPV co-infections accounted for 23.6%. In this study, HPV was not genotyped in 14,4% of women.…”

Section: Molecular Prevalence Of Hpv and Genotypes In Hiv+ Women Accomentioning

confidence: 99%

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

Freitas

Suehiro²,

Consolaro³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Human papillomavirus is a virus that is distributed worldwide, and persistent infection with high-risk genotypes (HR-HPV) is considered the most important factor for the development of squamous cell cervical carcinoma (SCC). However, by itself, it is not sufficient, and other factors may contribute to the onset and progression of lesions. For example, infection with other sexually transmitted diseases such as human immunodeficiency virus (HIV) may be a factor. Previous studies have shown the relationship between HPV infection and SCC development among HIV-infected women in many regions of the world, with great emphasis on low-and middleincome countries (LMICs). Brazil is considered a LMIC and has great disparities across different regions. The purpose of this review was to highlight the current knowledge about HPV infection and cervical abnormalities in HIV+ women in Brazil because this country is an ideal setting to evaluate HIV impact on SCC development and serves as model of LMICs and low-resource settings.

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“…This increased risk for cervical cancer has led to increased follow-up and closer screening recommendations. 11,12 Most of these data came before antiretroviral medications were consistently in use 4,13 and data in the combined antiretroviral therapy (cART) era are just emerging, 14 particularly around progression and regression.…”

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confidence: 99%

Progression and Regression of Cervical Pap Test Lesions in an Urban AIDS Clinic in the Combined Antiretroviral Therapy Era: A Longitudinal, Retrospective Study

Lofgren

Tadros

Herring-Bailey

et al. 2015

AIDS Research and Human Retroviruses

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Our objective was to evaluate the progression and regression of cervical dysplasia in human immunodeficiency virus (HIV)-positive women during the late antiretroviral era. Risk factors as well as outcomes after treatment of cancerous or precancerous lesions were examined. This is a longitudinal retrospective review of cervical Pap tests performed on HIV-infected women with an intact cervix between 2004 and 2011. Subjects needed over two Pap tests for at least 2 years of follow-up. Progression was defined as those who developed a squamous intraepithelial lesion (SIL), atypical glandular cells (AGC), had low-grade SIL (LSIL) followed by atypical squamous cells-cannot exclude high-grade SIL (ASC-H) or high-grade SIL (HSIL), or cancer. Regression was defined as an initial SIL with two or more subsequent normal Pap tests. Persistence was defined as having an SIL without progression or regression. High-risk human papillomavirus (HPV) testing started in 2006 on atypical squamous cells of undetermined significance (ASCUS) Pap tests. AGC at enrollment were excluded from progression analysis. Of 1,445 screened, 383 patients had over two Pap tests for a 2-year period. Of those, 309 had an intact cervix. The median age was 40 years and CD4 + cell count was 277 cells/mL. Four had AGC at enrollment. A quarter had persistently normal Pap tests, 64 (31%) regressed, and 50 (24%) progressed. Four developed cancer. The only risk factor associated with progression was CD4 count. In those with treated lesions, 24 (59%) had negative Pap tests at the end of follow-up. More studies are needed to evaluate follow-up strategies of LSIL patients, potentially combined with HPV testing. Guidelines for HIV-seropositive women who are in care, have improved CD4, and have persistently negative Pap tests could likely lengthen the followup interval.

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Incidence of cervical intraepithelial neoplasia in a cohort of HIV‐infected women

Abstract: The CIN incidence was low despite the high HPV prevalence. Being younger than 19 years at first sexual intercourse and not using antiretroviral medications were found to be the main risk factors for CIN.

Cited by 14 publications

References 25 publications

Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia

Human papillomavirus detection in women with and without human immunodeficiency virus infection in Colombia

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

Progression and Regression of Cervical Pap Test Lesions in an Urban AIDS Clinic in the Combined Antiretroviral Therapy Era: A Longitudinal, Retrospective Study

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