Incident High-Grade Squamous Intraepithelial Lesions in Senegalese Women With and Without Human Immunodeficiency Virus Type 1 (HIV-1) and HIV-2

Hawes, Stephen E.; Critchlow, Cathy W.; Sow, Papa Salif; Touré, Papa Souleymane; N'Doye, Ibraham; Diop, Aissatou; Kuypers, Jane; Kasse, A. A.; Kiviat, Nancy B.

doi:10.1093/jnci/djj010

Cited by 96 publications

(85 citation statements)

References 41 publications

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“…Comparable studies using PCR-based detection of HPV in HIV-infected women have reported 12 -79% of study participants with multiple HPV types (Levi et al, 2002;Moscicki et al, 2004;Bollen et al, 2006;Didelot-Rousseau et al, 2006;Hawes et al, 2006;Luque et al, 2006). This high prevalence may reflect the immune impairment by HIV that fails to clear HPV, leading to chronic HPV infection.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and distribution of HPV genotypes among HIV-infected women in Zambia

et al. 2007

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We screened 145 HIV-infected non-pregnant women at a tertiary care centre in Lusaka, Zambia. Liquid-based cytology and human papillomavirus (HPV) genotyping with PGMY09/11 biotinylated primers (Roche Linear Array s HPV genotyping test) maximised sensitivity of cytology and HPV assessments. Among high-risk (HR) types, HPV 52 (37.2%), 58 (24.1%) and 53 (20.7%) were more common overall than HPV 16 (17.2%) and 18 (13.1%) in women with high-grade squamous intraepithelial lesions or squamous cell carcinoma (SCC) on cytology. High-risk HPV types were more likely to be present in women with CD4 þ cell counts o200 m l À1(odds ratios (OR): 4.9, 95% confidence intervals (CI): 1.4 -16.7, P ¼ 0.01) and in women with high-grade or severe cervical cytological abnormalities (OR: 8.0, 95% CI: 1.7 -37.4, P ¼ 0.008). Human papillomavirus diversity in high-grade lesions and SCC on cytology suggests that HPV 16-and 18-based vaccines may not be adequately polyvalent to induce protective immunity in this population.

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Section: Discussionmentioning

confidence: 99%

Prevalence and distribution of HPV genotypes among HIV-infected women in Zambia

et al. 2007

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“…Six et al 21 , em estudo comparativo entre mulheres positivas e negativas para o HIV, obtiveram prevalências de SIL de 31,3 e 7,5%, respectivamente, resultados mais significativos do que os de Schuman et al 22 , que salientaram prevalências respectivas de 19 e 5%, e os de Singh et al 23 , com resultados de 15,9 e 1,5%, utilizando a citologia oncótica para o diagnóstico. No que diz respeito somente a mulheres positivas para o HIV, estudo africano utilizando a citologia encontrou prevalência de SIL de 12,3% 24 , enquanto o estudo chinês já citado, também utilizando a citologia oncótica, e incluindo ASCUS, encontrou 16% de SIL 20 . Estudos brasileiros utilizando a biópsia de colo uterino registraram prevalência de NIC de 23,4% em 494 mulheres HIV-positivas do Estado de Minas Gerais 25 , e de 18% em 255 mulheres HIV-positivas na cidade de São Paulo 26 .…”

Section: Métodosunclassified

“…A prevalência de infecção cervical pelo HPV é mais alta nas mulheres positivas para o HIV, com índices variando na literatura de 34 a 98% 20,[22][23][24][25][26][29][30][31] . Metanálise envolvendo 5.578 pacientes com HIV positivo com citologia oncótica normal em vários países encontrou média de prevalência de infecção pelo HPV de 36,3%, sendo que os mais altos índices foram nas Américas do Sul e Central: 56,6% 32 .…”

Section: Métodosunclassified

Prevalência de infecção cervical por papilomavírus humano e neoplasia intraepitelial cervical em mulheres HIV-positivas e negativas

Ceccato¹,

Lopes²,

Nascimento³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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Resumo OBJETIVO: Realizar estudo comparativo entre mulheres positivas e negativas para o vírus da imunodeficiência humana (HIV), analisando: prevalência de neoplasia intraepitelial cervical (NIC) e infecção cervical pelo papilomavírus humano (HPV); risco viral e relação com desenvolvimento de NIC; parâmetros sociodemográficos e de comportamento que influenciaram na presença de infecção cervical por HPV e NIC. MÉTODOS: Estudo comparativo entre mulheres positivas e negativas para o HIV, sendo analisadas, respectivamente, 202 e 171 mulheres para avaliar a prevalência de NIC e 164 e 100 mulheres para avaliar a prevalência de infecção cervical pelo HPV. Em todas as consultas foram realizados: coleta de amostras cervicais para realização de citologia oncótica e reação em cadeia da polimerase (PCR) para detecção do DNA-HPV; colposcopia; questionário padronizado para coleta de dados demográficos/comportamentais; biópsia de todas as alterações colposcópicas. O exame histopatológico foi o padrão-ouro para o diagnóstico de NIC. RESULTADOS: A prevalência de NIC foi de 2,4 e 15,3% (p<0,001) e de infecção cervical pelo HPV foi de 37,1 e 55,5% (p=0,002), respectivamente, nas negativas e positivas para o HIV. As soropositivas tiveram mais infecção por HPV de alto risco (35,7 e 23,6%; p=0,02) e por múltiplos tipos (6,2 e 0%). O HPV 16 foi o tipo prevalente, ocorrendo em 11,3 e 10,2% das positivas e negativas para o HIV e também nas mulheres que tiveram NIC nos dois grupos. Os fatores associados ao desenvolvimento de NIC foram: infecção pelo HIV (HT=4,64; IC95% 2,23-9,65), idade (HT=0,95; IC95% 0,93-0,98 para cada ano de vida) e estado civil (HT=0,49; IC95% 0,30-0,80). Os fatores associados à infecção pelo HPV foram: presença do HIV (HT=2,72; IC95% 1,77-4,17), maior número de parceiros sexuais (HT=1,87; IC95% 1,23-2,84), idade (HT=0,97; IC95% 0,95-0,99 para cada ano de vida) e estado civil (HT=0,65: IC95% 0,42-1,0 para união estável/viúvas). CONCLUSÃO: A prevalência de NIC e infecção cervical pelo HPV foi maior nas mulheres positivas para o HIV, que também apresentaram mais infecções por HPV de alto risco e múltiplos tipos. O tipo 16 foi o predominante nos dois grupos e nas mulheres que tiveram NIC. As mulheres com mais idade e união estável/viúvas tiveram menor chance de adquirir infecção cervical por HPV e NIC. AbstractPURPOSE: To conduct a comparative study between two groups of women (HIV positive and negative) analyzing: the prevalence of cervical intraepithelial neoplasia (CIN) and cervical HPV infection; viral risk and relationship with development of CIN; and sociodemographic and behavioral parameters that influence cervical HPV infection and the development of CIN. METHODS: A cross-sectional study in which 202 HIV-positive women and 164 HIV-negative women were analyzed to assess the prevalence of CIN and 171 HIV-positive women and 160 HIV-negative women were analyzed to assess the prevalence of cervical HPV infection. The following procedures were performed on the occasion of each medical visit: collection of cervical sa...

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“…In our study, the risk of CIN21 and CIN31 among WLWH compared to HIV negative women was larger than expected from several earlier reports. 4,[18][19][20][21] This high risk was driven by the large discrepancy in risk between migrants with and without HIV. Surprisingly, little is known regarding the risk of CIN21 and CIN31 among migrant women living with HIV from countries with high incidence of cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Impact of immunosuppression and region of birth on risk of cervical intraepithelial neoplasia among migrants living with HIV in Sweden

Carlander

Wagner

Svedhem

et al. 2016

Intl Journal of Cancer

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Little is known about the incidence and risk of cervical intraepithelial neoplasia (CIN) grade 3, adenocarcinoma in situ and invasive cervical cancer (CIN31) among migrants living with HIV in a European setting. We assessed the cumulative incidence (CuI) and hazard ratio (HR) of CIN21 and CIN31 in a cohort of women living with HIV (WLWH) (n 5 893) identified from the Swedish national HIV register and HIV-negative women (n 5 205,842) identified from the Swedish Population Register, matched on region of birth and age. Data was collected between 1993 and 2011 by linking our cohort with the Swedish National Cervical Screening Registry, collecting all cytological and histological results since 1993. The CuI of CIN31 was 13.1% [95% confidence interval (CI) 8.9-17.2] for WLWH and 2.1% (95% CI 2.0-2.2) for HIV-negative after 18 years of follow-up. WLWH had more than eight times higher, age and region of birth matched, risk of CIN31 than HIV-negative (HR 8.8: 95% CI 6.9-11.3). WLWH born in the East region, dominated by Thai women, had a two times higher risk of CIN31 compared with WLWH born in Sweden (HR 2.47: 95% CI 1.2-5.0), which remained after adjusting for immunosuppression. Our results showed a substantially increased risk of CIN31 among WLWH, which differed depending on birth region. Early HIV diagnosis and attendance to cervical cancer screening, with focus on migrants, is of crucial importance to minimize the incidence of cervical intraepithelial neoplasia.Women living with HIV (WLWH) are more likely than HIV-negative women to have persistent high risk-Human Papillomavirus (hr-HPV) cervical infections 1,2 and to develop cervical intraepithelial neoplasia grade 3, adenocarcinoma in situ and invasive cervical cancer (CIN31). 3,4 The risk of CIN31 increases with the degree of immunosuppression [5][6][7]

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Incident High-Grade Squamous Intraepithelial Lesions in Senegalese Women With and Without Human Immunodeficiency Virus Type 1 (HIV-1) and HIV-2

Abstract: HIV-1 and HIV-2 are associated with increased risk for development of HSIL. This risk appears to be associated primarily with increased HPV persistence that may result from immunosuppression related to HIV-1 and/or HIV-2 infection.

Cited by 96 publications

References 41 publications

Prevalence and distribution of HPV genotypes among HIV-infected women in Zambia

Prevalence and distribution of HPV genotypes among HIV-infected women in Zambia

Prevalência de infecção cervical por papilomavírus humano e neoplasia intraepitelial cervical em mulheres HIV-positivas e negativas

Impact of immunosuppression and region of birth on risk of cervical intraepithelial neoplasia among migrants living with HIV in Sweden

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