Document Detail


Prevalence and determinants of human papillomavirus infection and cervical lesions in HIV-positive women in Kenya.
MedLine Citation:
PMID:  23033006     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: We assessed the association of human papillomavirus (HPV) infection and cervical intraepithelial neoplasia (CIN) with various characteristics, CD4 count and use of combination antiretroviral therapy (cART) among HIV-positive women.
METHODS: Cross-sectional study of 498 HIV-positive women who underwent HPV PCR-based testing, cytology, and systematic cervical biopsy.
RESULTS: In all, 68.7% of women were HPV-positive, 52.6% had high-risk (hr) HPV, and 40.2% multiple type infections. High-risk human papillomavirus-positivity did not vary significantly by age but it was negatively associated with education level. The most frequent types in 113 CIN2/3 were HPV16 (26.5%), HPV35 (19.5%), and HPV58 (12.4%). CD4 count was negatively associated with prevalence of hrHPV (P<0.001) and CIN2/3 among non-users of cART (P=0.013). Combination antiretroviral therapies users (≥2 year) had lower hrHPV prevalence (prevalence ratio (PR) vs non-users=0.77, 95% confidence interval (CI): 0.61-0.96) and multiple infections (PR=0.68, 95% CI: 0.53-0.88), but not fewer CIN2/3. The positive predictive value of hrHPV-positivity for CIN2/3 increased from 28.9% at age <35 years to 53.3% in ≥45 years.
CONCLUSION: The burden of hrHPV and CIN2/3 was high and it was related to immunosuppression level. Combination antiretroviral therapies ( ≥2 year) use had a favourable effect on hrHPV prevalence but cART in our population may have been started too late to prevent CIN2/3.
Authors:
H De Vuyst; N R Mugo; M H Chung; K P McKenzie; E Nyongesa-Malava; V Tenet; J W Njoroge; S R Sakr; Cjl M Meijer; P J F Snijders; F S Rana; S Franceschi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-02
Journal Detail:
Title:  British journal of cancer     Volume:  107     ISSN:  1532-1827     ISO Abbreviation:  Br. J. Cancer     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-24     Completed Date:  2013-03-21     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  0370635     Medline TA:  Br J Cancer     Country:  England    
Other Details:
Languages:  eng     Pagination:  1624-30     Citation Subset:  IM    
Affiliation:
International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, Lyon, France. devuysth@iarc.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Cervical Intraepithelial Neoplasia / epidemiology*,  virology
Cohort Studies
Cross-Sectional Studies
Female
HIV Infections / epidemiology*,  virology
Humans
Kenya / epidemiology
Middle Aged
Papillomavirus Infections / epidemiology*,  virology
Prevalence
Uterine Cervical Neoplasms / epidemiology*,  virology
Grant Support
ID/Acronym/Agency:
5K23AI065222-04/AI/NIAID NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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