Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women

Teixeira, Nara Chartuni Pereira; Araújo, Angela Cristina Labanca de; Corrêa, Christine Miranda; Lodi, Claudia Teixeira da Costa; Lima, Maria Inês Miranda; Carvalho, Nara de Oliveira; Castillo, Dora Méndez del; Melo, Victor Hugo

doi:10.1016/s1413-8670(12)70299-4

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…HPV-35 was the most prevalent in seropositive women with a frequency of 49.4%. Our results are in agreement with previous studies which reported that the prevalence of HPV infection is higher among HIV-seropositive women 15–22. In Tanzania and South Africa Dols et al23 reported that the most frequent HPV-HR in HIV positive women were HPV-52 (30%) and HPV-16 (26%), there was no regional difference in the prevalence of HPV-18 and HPV-35.…”

Section: Discussionsupporting

confidence: 93%

Prevalence of HPV High-Risk Genotypes in Three Cohorts of Women in Ouagadougou (Burkina Faso)

Zohoncon¹,

Simporé

2013

Mediterr J Hematol Infect Dis

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The development of cervical cancer is associated with high-risk Human papilloma viruses (HPV-HR). In sub-Saharan Africa cervical cancer is the most common cancer among women and the leading cause of death attributed to malignant tumors. This study aims to identify HPV genotypes within the 30′S and 50′S HPV families found in two previous studies from our laboratory, and to determine the prevalence of twelve HPV-HR genotypes in a population of women in Ouagadougou. The twelve HPV-HR genotypes were determined by real-time multiplex PCR, in 180 samples from the general population and among a group of HIV-1 infected women.The most common genotypes found were HPV-35 (29.4%) and HPV-31 (26.1%) of the 30′S family, and HPV-52 (29.4%) and HPV-58 (20.6%) of the 50′S family. Multiple infections of HPV-HR were observed in 78.03% of infected women.The frequencies of HPV genotypes from the 30′S and 50′S families were higher, while the genotypes HPV-16 and18 were lower among the women in our study.

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Section: Discussionsupporting

confidence: 93%

Prevalence of HPV High-Risk Genotypes in Three Cohorts of Women in Ouagadougou (Burkina Faso)

Zohoncon¹,

Simporé

2013

Mediterr J Hematol Infect Dis

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“…Interestingly, our study findings are in accordance with a very recent study in which the investigators observed similar rates of HPV infection and cervical pathology 10. Moreover, in studies among HIV-infected women in Sao Paolo, Rio De Janeiro, and Belo Horizonte, Brazil, 13%, 24%, and 24% had a diagnosis of squamous intraepithelial lesions, respectively 11–13. In studies in Cambodia, Thailand, and People’s Republic of China, the prevalence of HSIL/LSIL among women attending HIV clinics was 17%, 16%, and 8%, respectively 8,14,15.…”

Section: Discussionsupporting

confidence: 92%

“…The absence of significant associations could be explained by the lack of power to detect these associations. Nevertheless, the degree of immunosuppression is expected to have an effect on the incidence and progression of squamous intraepithelial lesions among HIV-infected women as it has been shown in several observational studies 13–17. To date, evidence on an independent association between ART and the natural history of HPV infection or the risk of squamous intraepithelial lesions and cervical cancer is contradictory and inconclusive 18–21.…”

Section: Discussionmentioning

confidence: 99%

HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mumbai, India: 12-month follow-up

Isaakidis¹,

Pimple²,

Varghese³

et al. 2013

IJWH

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BackgroundHIV-infected women are at a higher risk of cervical intraepithelial neoplasia (CIN) and cancer than women in the general population, partly due to a high prevalence of persistent human papillomavirus (HPV) infection. The aim of the study was to assess the burden of HPV infection, cervical abnormalities, and cervical cancer among a cohort of HIV-infected women as part of a routine screening in an urban overpopulated slum setting in Mumbai, India.MethodsFrom May 2010 to October 2010, Médecins Sans Frontières and Tata Memorial Hospital Mumbai offered routine annual Pap smears and HPV DNA testing of women attending an antiretroviral therapy (ART) clinic and a 12-month follow-up. Women with abnormal test results were offered cervical biopsy and treatment, including treatment for sexually transmitted infections (STIs).ResultsNinety-five women were screened. Median age was 38 years (IQR: 33–41); median nadir CD4-count 143 cells/μL (IQR: 79–270); and median time on ART 23 months (IQR:10–41). HPV DNA was detected in 30/94 women (32%), and 18/94 (19%) showed either low-grade or high-grade squamous intraepithelial lesions (LSIL/HSIL) on Pap smear. Overall, >50% had cervical inflammatory reactions including STIs. Of the 43 women with a cervical biopsy, eight (8.4%) had CIN-1, five (5.3%) CIN-2, and two (2.1%) carcinoma in situ. All but one had HPV DNA detected (risk ratio: 11, 95% confidence interval: 3.3–34). By October 2011, 56 women had completed the 12-month follow-up and had been rescreened. No new cases of HPV infection/LSIL/HSIL were detected.ConclusionThe high prevalence of HPV infection, STIs, and cervical lesions among women attending an ART clinic demonstrates a need for routine screening. Simple, one-stop screening strategies are needed. The optimal screening interval, especially when resources are limited, needs to be determined.

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“…Increased metaplastic activity in the cervix during adolescence and its decline after menopause implica earlier age at sexual debut as a risk factor for HPV infection. Other factors related to HPV infection or persistence include young age, the socioeconomic status, multiparity, male circumcision, condom use, oral contraceptive use, smoking, immune suppression, viral load, and certain genetic polymorphisms 26, 91, 73, 89, 34, 32, 71, 83, 86, 30 40, 62, 82, 69, 68, 11, 67, 35, 61 90, 72, 66, 54, 6, 84, 59, 43 44, 31, 42, 45, 74, 33, 81, 70 51, 58, 53, 56 52 18 16 in the human leukocyte antigen system (Moscicki et al, 2001;Palefsky et al, 2001;Maciag et al, 2002;Schlecht et al, 2002;Richardson et al, 2003;Winer et al, 2003;Baldwin et al, 2004;Baseman and Koutsky, 2005;Cotton et al, 2007;Goodman et al, 2008;Tobian et al, 2009;Tobian et al, 2010;Marks et al, 2011;Bahmanyar et al, 2012;Emeka et al, 2012;Liao et al, 2012;Repp et al, 2012;Schabath et al, 2012;Teixeira et al, 2012;Zhang et al, 2012).…”

Section: Epidemiology Of Human Papillomavirus Infectionsmentioning

confidence: 99%

Review of the current knowledge on the epidemiology, pathogenesis, and prevention of human papillomavirus infection

Asiaf

Ahmad

Mohammad

et al. 2014

European Journal of Cancer Prevention

102

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Human papillomavirus (HPV) infection is a central and necessary, although not sufficient, cause of cervical cancer. Besides HPV, the additional multiple risk factors related with the onset of cervical cancer are early-age sexual activities; high number of sexual partners, which is the most salient risk factor; suppression and alteration of the immune status; long-term use of oral contraceptives; and other hormonal influences. The tumor-suppressor proteins p53 and pRb are degraded and destabilized through ubiquitination by viral oncoproteins E6 and E7. Over 95% of cervical cancer cases worldwide test positive for oncogenic HPV DNA. Although cervical screening procedures have been successful in reducing the disease burden associated with HPV infection because of lack of resources or inadequate infrastructure many countries have failed to reduce cervical cancer mortality. Therefore, prevention may be a valuable strategy for reducing the economic and disease burden of HPV infection. At present, two successful prophylactic HPV vaccines are available, quadrivalent (HPV16/18/6/11) 'Gardasil' and bivalent (HPV16/18) 'Cervarix' for vaccinating young adolescent girls at or before the onset of puberty. Recent data indicate that vaccination prevents the development of cervical lesions in women who have not already acquired the vaccine-specific HPV types. Moreover, several therapeutic vaccines that are protein/peptide-based, DNA-based, or cell-based are in clinical trials but are yet to establish their efficacy; these vaccines are likely to provide important future health benefits. The therapeutic vaccination mode of prevention is a promising area of research, as revealed in preclinical trials; however, clinical trials based on large populations are warranted before reaching a valid conclusion. This review summarizes the studies on the epidemiology of HPV infection, the pathogenesis of viral oncoproteins in the oncogenesis of cervical cancer, the economic and health burden of HPV-related diseases, and, finally, focuses on the results of recent clinical vaccination trials.

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Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women

Abstract: Severity of immunosuppression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infected women.

Cited by 11 publications

References 25 publications

Prevalence of HPV High-Risk Genotypes in Three Cohorts of Women in Ouagadougou (Burkina Faso)

Prevalence of HPV High-Risk Genotypes in Three Cohorts of Women in Ouagadougou (Burkina Faso)

HPV infection, cervical abnormalities, and cancer in HIV-infected women in Mumbai, India: 12-month follow-up

Review of the current knowledge on the epidemiology, pathogenesis, and prevention of human papillomavirus infection

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