title: High risk of human papillomavirus infection and cervical squamous intraepithelial lesions among women with symptomatic human immunodeficiency virus infection.
abstract: We investigated the relationship of human papillomavirus (by cervicovaginal lavage and Southern blot), human immunodeficiency virus, and squamous intraepithelial lesions in 96 high-risk women in the Bronx, New York. Antibodies for human immunodeficiency virus were detected in 51 (53%) women. Of the 33 women with symptomatic human immunodeficiency virus infection, 23 (70%) had human papillomavirus infection compared with 4 of 18 (22%) asymptomatic women who were human immunodeficiency virus seropositive and 10 of 45 (22%) uninfected women (p less than 0.0001). The rate of squamous intraepithelial lesions was 52% (14 of 27) for women with both viruses detected, 18% (6 of 34) for women with either virus detected, and 9% (3 of 35) for uninfected women. Among symptomatic human immunodeficiency virus-infected women, a strong association between human papillomavirus infection and squamous intraepithelial lesions was demonstrated (odds ratio, 12; 95% confidence interval, 1.3 to 108). Risk was highest for younger women from ethnic or racial minority groups. Advanced human immunodeficiency virus-related disease, with its associated immunosuppression, seems to exacerbate human papillomavirus-mediated cervical cytologic abnormalities. Public health measures are needed to provide Papanicolaou smear screening and appropriate clinical follow-up and treatment for women at high risk for human immunodeficiency virus infection.
authors.affiliation: Department of Epidemiology, Montefiore Medical Center, Bronx, New York.
authors.forename: S H
authors.initials: SH
authors.lastname: Vermund
authors.forename: K F
authors.initials: KF
authors.lastname: Kelley
authors.forename: R S
authors.initials: RS
authors.lastname: Klein
authors.forename: A R
authors.initials: AR
authors.lastname: Feingold
authors.forename: K
authors.initials: K
authors.lastname: Schreiber
authors.forename: G
authors.initials: G
authors.lastname: Munk
authors.forename: R D
authors.initials: RD
authors.lastname: Burk
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D000328:Adult; D015139:Blotting, Southern; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000235:genetics; D002584:Cervix Uteri / Q000473:pathology; D002985:Clinical Protocols; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D027383:Papillomaviridae; D012306:Risk; D014412:Tumor Virus Infections / Q000453:epidemiology* / Q000235:genetics; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000235:genetics; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D015215:Zidovudine