title: Risk factors for squamous intraepithelial lesions on Pap smear in women at risk for human immunodeficiency virus infection.
abstract: To determine risk factors for squamous intraepithelial lesions (SIL) on Pap smear, 253 women at risk for human immunodeficiency virus (HIV) infection had Pap smear, HIV antibody testing, CD4+ cell measurements, and human papillomavirus (HPV) genome detection by Southern blot hybridization. Associated with SIL (P < .05) on univariate analysis were genital HPV (SIL prevalence in HPV-positive subjects, 36.3%; odds ratio [OR], 9.3; 95% confidence interval [CI], 4.2-20.3) and HIV infection (SIL prevalence in seropositive subjects, 21.9%; OR, 2.5; 95% CI, 1.2-5.1). No demographic or behavioral variables were associated with risk for SIL. Multivariate analyses identified genital HPV infection (OR, 6.78; 95% CI, 2.9-15.7), detection of known high-risk HPV types (OR, 11.8; 95% CI, 4.1-34.1), strong HPV Southern blot signal strength (OR, 10.8; 95% CI, 3.5-33.7), and severe HIV-related immunosuppression (OR, 3.1; 95% CI, 1.04-9.5) as independent risk factors associated with SIL. Thus, severe immunosuppression due to HIV infection increases the risk for SIL mediated by HPV infection.
authors.affiliation: Department of Medicine, Montefiore Medical Center, Bronx, New York.
authors.forename: R S
authors.initials: RS
authors.lastname: Klein
authors.forename: G Y
authors.initials: GY
authors.lastname: Ho
authors.forename: S H
authors.initials: SH
authors.lastname: Vermund
authors.forename: I
authors.initials: I
authors.lastname: Fleming
authors.forename: R D
authors.initials: RD
authors.lastname: Burk
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D002294:Carcinoma, Squamous Cell / Q000150:complications*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged; D015999:Multivariate Analysis; D009518:New York; D016017:Odds Ratio; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications; D015995:Prevalence; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000150:complications; D002583:Uterine Cervical Neoplasms / Q000150:complications*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000150:complications*
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies