Prevalence and Risk Factors for Anal Human Papillomavirus Infection in Human Immunodeficiency Virus (HIV)–Positive and High‐Risk HIV‐Negative Women

Palefsky, Joel M.; Holly, Elizabeth A.; Ralston, Mary L.; Costa, Maria Da; Greenblatt, Ruth M.

doi:10.1086/318071

Cited by 300 publications

(269 citation statements)

References 34 publications

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“…Low CD4+ T lymphocyte cell counts significantly increased the likelihood of having cervical SIL, with most of the lesions seen at CD4+ T Lymphocyte cell counts below 200cells/µL. This is in agreement with most reports on rate of cervical SIL and HIV infection (Wright et al, 1994;Massad, 1999), possibly due to reactivation and persistent infection with the higher risky HPV such as type 16 and 18 (Wright et al, 1994;Palefsky et al, 2001). The significant statistical difference between the degree of immunosupression (by CD4+ T-lymphocyte cell counts) and the degree of cervical SIL shows that the more the immunity is suppressed the higher the likelihood of having high grade cervical SIL.…”

Section: Discussionsupporting

confidence: 86%

“…This group was also seen to have a higher rate of HIV infection compared to married/cohabiting women). Multiple partners and HIV infection are factors highly associated with higher rates HPV infections, persistence and progression to SIL (Palefsky et al, 2001;Massad, 1999). A similar trend, however insignificant was seen with single/widowed developing HGL compared to married women in a West African study (La Ruche et al, 1998).…”

Section: Discussionmentioning

confidence: 73%

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Prevalence and severity of cervical squamous intraepithelial lesion in a tertiary hospital in northern Tanzania

Obure

Olola²,

Swai³

et al. 2010

Tanzania J Hlth Res

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Cervical cancer is the second most common cancer in women worldwide and the leading cause of cancer deaths in Tanzanian women. Prevention of cervical cancer relies on the detection and treatment of Squamous Intraepithelial Lesion (SIL), a premalignant disease stage. Worldwide there are overwhelming reports associating SIL and HIV infection, however in Tanzania such reports are limited. A cross-sectional hospital-based descriptive study was conducted to determine the prevalence and severity of SIL in 234 HIV seropositive and seronegative women aged 18-68 years old at Kilimanjaro Christian Medical Centre in northern Tanzania. A structured questionnaire was used to collect sociodemographic data. In addition, blood was collected for rapid HIV antibody testing and CD4+ T-lymphocyte counts to associate with prevalence and severity of SIL from the cervical smear collections. A total of 214 subjects had smear results regarded as valid for interpretation, of which 46.3% were HIV seropositive. Overall rate of SIL was 17%. Proportion of SIL among HIV seropositive subjects was 32% versus 4% in seronegative subjects (OR=13.3, 95% CI=4.2-46.4). Low CD4+ Tlymphocyte cell count was associated with higher prevalence of SIL (P=0.001). The relationship between CD4+ T-lymphocyte cell counts and the severity of cervical SIL was significant (P=0.007). Marital status and number of lifetime sex partners were risk factors significantly associated with SIL (P=0.004 and 0.005, respectively). SIL was not associated with age, education level, parity or age at sex debut. The prevalence and severity of cervical SIL was significantly associated with HIV infection and immunologic disease progression. These findings underscore the need for HIV screening among women with SIL, and the need for cervical cancer screening in HIV-infected women. Marital status and number of lifetime sex partners were significant risk factors associated with SIL. _______________________________________________________________________________________

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 73%

Prevalence and severity of cervical squamous intraepithelial lesion in a tertiary hospital in northern Tanzania

Obure

Olola²,

Swai³

et al. 2010

Tanzania J Hlth Res

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“…However, our data appear to be consistent with many other populations of HIV-infected women and men, where a significant increase in anogenital HPV prevalence and multiple infections has been reported. 18 The fact that genotypes other than HPV-16 are seen at relatively high frequency in this population may also be due to HIV, as others have reported that these HPV types, but not HPV-16, are more likely to increase in prevalence following HIV seroconversion (R. Burk, personal communication). Together, these data are important to the design of rational vaccine strategies in the sub-Saharan African nations.…”

Section: Dear Sirmentioning

confidence: 81%

Human papillomavirus genotype prevalence in high‐grade squamous intraepithelial lesions and colposcopically normal women from Zimbabwe

Gravitt

Kamath

Gaffikin³

et al. 2002

Intl Journal of Cancer

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Dear Sir,The paradigm shift that has occurred in the last decade attributing most, if not all, cervical cancers to infection with human papillomavirus (HPV) has renewed efforts to control cervical cancer, especially in developing countries where it remains the leading cause of cancer deaths among women. Primary and secondary prevention efforts have begun to focus on detection and control of the virus, specifically HPV DNA testing for screening [1][2][3][4][5][6][7] and HPV vaccine development for prevention. 8 Critical to the success of HPV-based prevention efforts is a comprehensive spectrum of targeted genotypes, given that at least 10 different HPV types have been classified as group 1 human carcinogens. 9 The International Biological Study of Invasive Cervical Cancer (IBSCC) demonstrated that certain HPV genotypes, namely, HPV-16, -18, -31 and -45, accounted for 80% of the sampled invasive cancers from 21 countries. 10,11 Based on these results, vaccine efforts are targeted first to HPV-16, with the hope of reducing the cervical cancer burden by up to 50%, presumably with vaccines targeting HPV-18, -31 and -45 to follow. However, a study in Mozambique found that HPV-35 was the most prevalent genotype, both in all HPV-positive women (16.7 %) and among women with cervical neoplasia (18.4%). 12 It is important to determine if this is a geographically isolated finding or if the relative prevalence of HPV types attributable to cervical cancer development differs in sub-Saharan Africa, where primary prevention offers the greatest promise of control. We report the genotype distribution of HPV from a nested case-control study of women originally enrolled in a visual inspection with acetic acid (VIA) screening study in Harare, Zimbabwe. 13 Study participants were drawn from subjects enrolled in phase II VIA screening study conducted jointly by the University of Zimbabwe in Harare and the JHPIEGO Corporation, a Johns Hopkins University affiliate based in Baltimore, MD, USA. Details of subject recruitment have been described elsewhere. 13 Briefly, subjects enrolled in phase II of the VIA screening study were recruited from October 1996 through August 1997 among women aged 25-55 years attending 15 primary-care clinics in Chitungwiza and the greater Harare area of Zimbabwe. All enrolled women provided verbal informed consent, and the institutional review boards of both participating institutions approved study protocols. Participants were interviewed using a standardized questionnaire to assess demographics. Following the interview, each participant consented to a pelvic exam with collection of cells for Pap smear and HPV DNA testing. VIA screening was performed last. All participants were offered a colposcopic examination of the cervix, and biopsies were collected if indicated, usually on the same day. At the colposcopy visit, consenting women (23%) provided an oral mucosal specimen (OraSure; Epitope, Beaverton, OR) for HIV antibody testing (duplicate testing via commercially available ELISA; Organon Teknica, Durham, NC...

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“…9 In fact, it has been reported that approximately 93% of HIV-positive men and 76% of HIV-positive women have anal HPV infection. 10,11 Overexpression of p16 has been proposed as a useful surrogate biomarker in the identification of squamous lesions harboring HPV DNA. A previous study has demonstrated that the degree of p16 overexpression correlates with the degree of dysplasia in the uterine cervix.…”

mentioning

confidence: 99%

Immunoreactivity of p16 in anal cytology specimens

Darvishian

Stier

Soslow

et al. 2006

Cancer

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Prevalence and Risk Factors for Anal Human Papillomavirus Infection in Human Immunodeficiency Virus (HIV)–Positive and High‐Risk HIV‐Negative Women

Cited by 300 publications

References 34 publications

Prevalence and severity of cervical squamous intraepithelial lesion in a tertiary hospital in northern Tanzania

Prevalence and severity of cervical squamous intraepithelial lesion in a tertiary hospital in northern Tanzania

Human papillomavirus genotype prevalence in high‐grade squamous intraepithelial lesions and colposcopically normal women from Zimbabwe

Immunoreactivity of p16 in anal cytology specimens

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