Prevalence and risk factors for cervical squamous intraepithelial lesions among women infected with HIV-1 in Makurdi, Nigeria

Abstract

BackgroundThe purpose of this study was to determine the prevalence and risk factors for cervical squamous intraepithelial lesions (SIL) among women infected with human immunodeficiency virus type 1 (HIV-1) receiving care at the Federal Medical Center Makurdi, Nigeria.MethodsBetween March and December 2009, a total of 253 women infected with HIV-1 had cervical smears taken for cytology. HIV-1 RNA viral load and CD4 counts were also measured.ResultsOf the 253 women, cervical SIL were present in 45 (17.8%). However, abnormal cervical cytology was noted in 146 (57.7%). Of those with abnormal cervical cytology, 101 (39.9%) women had atypical squamous cells of undetermined significance, 16 (6.3%) had low-grade SIL, and 29 (11.5%) women had high-grade SIL. The median CD4 lymphocyte count was lower in participants with cervical SIL compared with those without (132 versus 184 cells/mm3; P = 0.03). The median HIV-1 RNA viral load was higher in women with cervical SIL (102,705 versus 64,391 copies/mL; P = 0.02). A CD4 lymphocyte count of <200 cells/mm3 and an HIV-1 RNA viral load of <10,000 copies/mL were found to be significantly associated with cervical SIL.ConclusionA high prevalence of cervical SIL was found among HIV-1-infected women in Makurdi, Nigeria. Increased immune suppression and HIV-1 viremia are significantly associated with cervical SIL.

The Association between HIV Infection, Antiretroviral Therapy and Cervical Squamous Intraepithelial Lesions in South Western Nigerian Women

“…The finding of significantly higher rate of SIL among the HIV positive women (14.3%) compared to the HIV negative (3.3%) in this study further supports the previously reported association between HIV, HPV and cervical precancerous lesions [15], [16], [28]–[30]. The prevalence of SIL among HIV positive women in this study is within the range of 10.9–17.8% reported among HIV positive women by Anorlu et al [31], Sewande et al [22] and Chalermchockcharoenkit et al [32] in Nigeria and Thailand but lower than rates reported among the HIV-positive women in Jos, Nigeria (29%) [19] and Helsinki Finland (33%) [33].…”

Prevalence and predictors of precancerous cervical lesions among HIV‐positive women in Jos, north‐central Nigeria

“…This may be true since HIV lowers the immunity level of an individual thereby giving room for opportunistic infections, such as HPV, which has been implicated as one of the major causes of cervical cancer. The danger of cervical squamous intraepithelial lesions (SILs) or cervical intraepithelial neoplasia (CINs) is that cervical malignant growth increases exponentially when HIV infection is in existence 7 . Invasive cervical cancer is normally the last outcome of a continuum insuccessive stages, which begins with precursor lesions of CIN or squamous intraepithelial neoplasia 8 .…”

Effects of malaria/helminthic coinfections on cervical cancer progression among sub Saharan African women on highly active antiretroviral therapy: A scoping review

“…This was the first report of any direct evidence that malarial infections might contribute to the risk of cervical pre-cancer and cancer. (Swende et al, 2012)…”

“…(Celum, 2004) (Mercader et al, 2001) Available data suggest that HIV-positive women with squamous abnormalities detected on their Pap smears have a significantly higher HIV viral load than women with negative Pap smears. (Cardillo et al, 2001) (Agaba et al, 2009) (Swende et al, 2012)…”