Document Detail


High-risk human papillomavirus in HIV-infected women undergoing cervical cancer screening in Lilongwe, Malawi: a pilot study.
MedLine Citation:
PMID:  24928579     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Rates of abnormal visual inspection with acetic acid and prevalence of high-risk human papillomavirus subtypes have not been well characterized in HIV-infected women in Malawi.
METHODS: We performed a prospective cohort study of visual inspection with acetic acid (N = 440) in HIV-infected women ages 25-59, with a nested study of human papillomavirus subtypes in first 300 women enrolled. Wilcoxon's Rank-Sum Test was used to compare continuous variables and Fisher's exact test was used to compare categorical variables between women with normal versus abnormal visual inspection with acetic acid.
RESULTS: Of 440 women screened, 9.5% (N = 42) had abnormal visual inspection with acetic acid with 69.0% (N = 29) having advanced disease not amenable to cryotherapy. Of 294 women with human papillomavirus results, 39% (N = 114) of women were positive for high-risk human papillomavirus infection. Only lower CD4 count (287 cells/mm(3) versus 339 cells/mm(3), p = 0.03) and high-risk human papillomavirus (66.7% versus 35.6%, p < 0.01) were associated with abnormal visual inspection with acetic acid. The most common high-risk human papillomavirus subtypes in women with abnormal visual inspection with acetic acid were 35 (33.3%), 16 (26.7%), and 58 (23.3%).
CONCLUSION: Low CD4 cell count was associated with abnormal visual inspection with acetic acid and raises the importance of early antiretroviral therapy and expanded availability of visual inspection with acetic acid. Human papillomavirus vaccines targeting additional non-16/18 high-risk human papillomavirus subtypes may have greater protective advantages in countries such as Malawi.
Authors:
Deepa Reddy; Joseph Njala; Penny Stocker; Alan Schooley; Martiniano Flores; Chi-Hong Tseng; Colin Pfaff; Perry Jansen; Ronald T Mitsuyasu; Risa M Hoffman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-13
Journal Detail:
Title:  International journal of STD & AIDS     Volume:  -     ISSN:  1758-1052     ISO Abbreviation:  Int J STD AIDS     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007917     Medline TA:  Int J STD AIDS     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
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