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Association between Cervical Dysplasia and Human Papillomavirus in HIV Seropositive Women from Johannesburg South Africa [Open Access]

Citation

Firnhaber, Cynthia; Van Le, Hoa; Pettifor, Audrey E.; Schulze, Doreen; Michelow, Pam; Sanne, Ian; Lewis, David A.; Williamson, Anna-Lise; Allan, Bruce; & Williams, Sophia, et al. (2010). Association between Cervical Dysplasia and Human Papillomavirus in HIV Seropositive Women from Johannesburg South Africa [Open Access]. Cancer Causes & Control, 21(3), 433-443. PMCID: PMC2835728

Abstract

OBJECTIVE: To examine the association between CD4 counts, HPV infection and the risk of cervical neoplasia among HIV-seropositive women. METHODS: A cross-sectional observational study was conducted among 1,010 HIV-seropositive women using cytology-based Pap smears. HPV DNA testing using Linear Array genotyping assay (Roche) was carried out in a subset of 191 patients. Multivariable-adjusted prevalence ratios (mPR) and 95% confidence intervals (CIs) were estimated with log-binomial regression. RESULTS: Among 1,010 HIV-seropositive women, the prevalence of AGC/ASCUS, LSIL and HSIL or greater was 8.3, 23.5 and 18.0%, respectively. The risk of cervical lesions was higher with CD4 < 200 cells/mm(3) vs. CD4 levels > 500/mm(3). HPV types 16 (41.7%) and HPV 56 (22.2%) were the most common types in HSIL cases. Women with CD4 levels < 200/mm(3) had a higher prevalence of HPV types 16 (p < 0.01) and 66 (p = 0.04). No statistical relationship between cervical lesions and HAART use was found. CONCLUSION: The burden of HPV infection and HSIL was high and correlated with HIV-induced immunosuppression. HPV 16 was the most common type in HSIL and increased in prevalence with greater immune suppression. Prophylactic HPV 16 vaccination could prevent approximately 40% of HSIL cases. Strengthening screening programs is imperative in this population.

URL

http://dx.doi.org/10.1007/s10552-009-9475-z

Reference Type

Journal Article

Year Published

2010

Journal Title

Cancer Causes & Control

Author(s)

Firnhaber, Cynthia
Van Le, Hoa
Pettifor, Audrey E.
Schulze, Doreen
Michelow, Pam
Sanne, Ian
Lewis, David A.
Williamson, Anna-Lise
Allan, Bruce
Williams, Sophia
Rinas, Allen
Levin, Simon
Smith, Jennifer S.

PMCID

PMC2835728