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

Brazilian Journal of Infectious Diseases

Carvalho, Nara de Oliveira¹  Correa, Christine Miranda³  Lima, Maria Inês Miranda³  Melo, Victor Hugo¹  Castillo, Dora Mendez del¹  Araújo, Angela Cristina Labanca³  Lodi, Claudia Teixeira da Costa²  Teixeira, Nara Chartuni Pereira³ 

[1] Universidade Federal de Minas Gerais, Belo Horizonte, Brazil;Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil;Department of Health Services, Belo Horizonte, Brazil

关键词: HIV;    DNA probes;    HPV;    Cervical intraepithelial neoplasia;    Immunosuppression;   

DOI  :  10.1590/S1413-86702012000200010

来源: Contexto

【 摘 要 】

OBJECTIVES: To evaluate the prevalence and the risk factors for cervical intraepithelial neoplasia (CIN) among HIV-infected women.
METHODS: Cross-sectional study of 494 HIV-infected women in Brazil, between 1998 and 2008. Gynecologic exam was performed, and samples were collected for cervical cytology and for HPV DNA detection. Cervical biopsy was carried out when indicated. HPV infection, CD4 T-lymphocyte count and HIV viral load were compared with cervical histopathology. Univariate and multivariate statistical analyses were performed to evaluate the statistical association of several risk factors.
RESULTS: CIN prevalence detected by histopathology was 23.4% (6% of CIN2/3 and 17.4% cases of CIN1). Multivariate analysis confirmed an independent association of CIN with CD4 T-lymphocyte count below 200 cells/mm³ (OR 5.0, 95% CI 2.5-10.1), with a positive detection of HPV DNA (OR 2.0, 95% CI 1.2-3.5), and with age < 34 years old (OR 1.5, 95% CI 1.0-2.4). HIV viral load and antiretroviral use were not independent risk factors for CIN.
CONCLUSIONS: Severity of immunosupression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infected women.

【 授权许可】

CC BY-NC-ND