Low‐grade squamous intraepithelial lesions among women with HIV

Manamela, Portia K.; Kgomo, Koena A.; Gelderen, C. J. Van; Lekha, Anushka R.; Michelow, Pamela; Berg, Eunice J van den; Adam, Yasmin

doi:10.1002/ijgo.12505

Cited by 5 publications

(8 citation statements)

References 22 publications

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“…Among women with LSIL cytology, the risk of underlying CIN2+ was significantly higher in HIV-positive women (40.9% vs. 13.6% in HIV-negative women) [ 9 ]. In a non-comparison study by Manamela et al [ 10 ]. in 652 HIV-infected women who had LSIL on cervical cytology, it was noted that the risk of underlying CIN2 or worse was high at nearly 60% and suggested that the practice of referral for colposcopy should continue.…”

Section: Discussionmentioning

confidence: 99%

HIV-Infected Women with Low-Grade Squamous Intraepithelial Lesion on Cervical Cytology Have Higher Risk of Underlying High-Grade Cervical Intraepithelial Neoplasia

Sakdadech

Muangmool

Srisomboon

2021

IJERPH

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Objective: To evaluate the risk of histological high-grade cervical lesions defined as cervical intraepithelial neoplasia grade 2 or worse (CIN2+) in women with human immunodeficiency virus (HIV) infection who had low-grade squamous intraepithelial lesions (LSIL) on cervical cytological screening compared with HIV-uninfected women who had similar cytology. Methods: 127 HIV-positive women aged 18–65 years with LSIL cytology undergoing colposcopic examination between January 2008 and December 2019 at Chiang Mai University Hospital were reviewed. By matching 1:1 ratio for age (±5 years) and examination time period (±12 months), 127 HIV-negative women with LSIL cytology in the same period were recruited as controlled subjects for comparison. The patients’ characteristics, HIV status, CD4 counts, antiretroviral therapy, and histopathology on cervical biopsy were analyzed. Results: HIV-infected women significantly had early sexual debut (age < 20 years) and more sexual partners (≥2) than HIV-uninfected women. The risk of underlying CIN2+ in HIV-infected women was significantly higher than that in HIV-negative women (20.5% vs. 9.4%, p = 0.021) with an odds ratio (OR) of 2.47 and 95% confidence interval (CI) = 1.18–5.14. After adjustment, the risk of underlying CIN2+ in HIV-infected women remained significantly higher than that in HIV-uninfected women (adjusted OR = 2.55, 95% CI = 1.11–5.82, p = 0.027). Conclusion: Among women with LSIL on cervical cytology, the risk of underlying CIN2+ in HIV-infected women was approximately 2.5 times higher than those without HIV infection. Colposcopy is indicated particularly in the case of women with a long duration of HIV infection.

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Section: Discussionmentioning

confidence: 99%

HIV-Infected Women with Low-Grade Squamous Intraepithelial Lesion on Cervical Cytology Have Higher Risk of Underlying High-Grade Cervical Intraepithelial Neoplasia

Sakdadech

Muangmool

Srisomboon

2021

IJERPH

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“…3 Approximately 63% of the women attending the colposcopy clinic at Chris Hani Baragwanath Academic Hospital 2 in Soweto, Johannesburg, have HIV/AIDS. 2 Diagnosis of Cervical intraepithelial lesion is by colposcopy followed by biopsy or loop electrosurgical excision procedure (LEEP). Immediate treatment using LEEP is the standard of care in many South African clinics when colposcopy is inadequate or when the colposcopy diagnosis is more severe than CIN 1.…”

Section: Introductionmentioning

confidence: 99%

“…Given the prevalence of HIV in South Africa, it is expected that women with HIV/AIDS contribute significantly to the burden of CIN disease or invasive cervical cancer 3 . Approximately 63% of the women attending the colposcopy clinic at Chris Hani Baragwanath Academic Hospital 2 in Soweto, Johannesburg, have HIV/AIDS 2 . Diagnosis of Cervical intraepithelial lesion is by colposcopy followed by biopsy or loop electrosurgical excision procedure (LEEP).…”

Section: Introductionmentioning

confidence: 99%

“…Women with HIV/AIDS have frequent, multiple, persistent infections with high-risk HPV, 1 which puts them at high risk of developing cervical intraepithelial neoplasia (CIN) and cervical cancer. 2 Given the prevalence of HIV in South Africa, it is expected that women with HIV/AIDS contribute significantly to the burden of CIN disease or invasive cervical cancer. 3 Approximately 63% of the women attending the colposcopy clinic at Chris Hani Baragwanath Academic Hospital 2 in Soweto, Johannesburg, have HIV/AIDS.…”

Section: Introductionmentioning

confidence: 99%

“…Women with HIV/AIDS have frequent, multiple, persistent infections with high‐risk HPV, 1 which puts them at high risk of developing cervical intraepithelial neoplasia (CIN) and cervical cancer 2 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Performance of the Swede score to predict cervical intraepithelial neoplasia in women with HIV‐1 in Johannesburg, South Africa

Maringa

Chikandiwa

Gilham

et al. 2020

Intl J Gynecology & Obste

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Objective To evaluate the performance of the Swede score to detect cervical intraepithelial neoplasia (CIN) in women with HIV‐1 in Johannesburg, South Africa. Methods A cross‐sectional study using secondary data analysis from the HPV in Africa Research Partnership (HARP) study that compared the performance of three different screening tests to detect CIN. Colposcopy was performed on any woman who screened positive and findings were recorded using the Swede score. A biopsy of any lesion and a four‐quadrant biopsy was taken. The score was evaluated against a histological diagnosis of >CIN1. The sensistivity, specificity, PPV and NPV for each score was calculated. Results Median age and CD4+ count of the 576 women eligible from the Johannesburg cohort was 34 years (IQR, 30–39) and 427 cells/mm3 (IQR, 323–579), respectively. Almost two‐thirds (64%) were on ART and about 21% had CIN 2+ on histology. A Swede score of 5 or greater had the best combination of sensitivity and specificity for CIN 2+ with an AUC of 0.72 (95% CI, 0.68–0.76) corresponding to a sensitivity of 72.1 (95% CI, 63.5–79.6) and specificity of 71.8 (95% CI, 67.4–75.9). Conclusion The Swede score can assist in determining whether women with HIV/AIDS should have treatment at the first colposcopy visit versus those who may be followed up, thereby individualizing treatment.

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A systematic review of the association between smoking exposure and HPV-related cervical cell abnormality among women living with HIV: Implications for prevention strategies

Zhao

Sekar

Bennis

et al. 2023

Preventive Medicine

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Low‐grade squamous intraepithelial lesions among women with HIV

Abstract: Most of the women with a cytology report of LSIL had CIN2 or higher, suggesting that the practice of referral for colposcopy should continue.

Cited by 5 publications

References 22 publications

HIV-Infected Women with Low-Grade Squamous Intraepithelial Lesion on Cervical Cytology Have Higher Risk of Underlying High-Grade Cervical Intraepithelial Neoplasia

HIV-Infected Women with Low-Grade Squamous Intraepithelial Lesion on Cervical Cytology Have Higher Risk of Underlying High-Grade Cervical Intraepithelial Neoplasia

Performance of the Swede score to predict cervical intraepithelial neoplasia in women with HIV‐1 in Johannesburg, South Africa

A systematic review of the association between smoking exposure and HPV-related cervical cell abnormality among women living with HIV: Implications for prevention strategies

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