title: HIV and human papillomavirus as independent risk factors for cervical neoplasia in women with high or low numbers of sex partners.
abstract: OBJECTIVE
  To explore whether HIV types 1 and 2 and CD4 cell count affect cervical neoplasia independent of human papillomavirus (HPV) in women with high or low numbers of sexual partners residing in Abidjan, Côte d'Ivoire.
  
  
  METHODS
  The study population and methods are described in the companion paper. Additional methods include a Papanicolaou smear for cytological diagnosis and statistical analysis.
  
  
  RESULTS
  In maternal women, both HIV-1 and high risk HPV were significant independent risk factors for squamous intraepithelial lesions (SIL) (adjusted odds ratio (OR) 11.0 (95% CI 1.1-112) and 5.4 (1.5-18.8), respectively). Only high levels of HPV DNA in the lavage were associated with SIL (OR 13.2 (3.6-47.8)) in the maternal group. In female sex workers, high risk HPV was significantly associated with SIL (OR 23.7 (4.4-126)); HIV seropositivity was not. Any positive level (high or low amounts) of HPV DNA was significantly associated with SIL in sex workers (ORs 15.9 (3.3-76) and 12.7 (3.6-44), respectively). There was no association of SIL with CD4 cell counts < or = 500 x 10(6)/l in HIV seropositive women from either group.
  
  
  CONCLUSIONS
  HPV or HIV-1 infection independently affect cervical neoplasia in women with low numbers of sex partners.
authors.affiliation: Centers for Disease Control and Prevention, Department of Health and Human Services, Atlanta, GA 30333, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Vernon
authors.forename: E R
authors.initials: ER
authors.lastname: Unger
authors.forename: M A
authors.initials: MA
authors.lastname: Piper
authors.forename: S T
authors.initials: ST
authors.lastname: Severin
authors.forename: S Z
authors.initials: SZ
authors.lastname: Wiktor
authors.forename: P D
authors.initials: PD
authors.lastname: Ghys
authors.forename: D L
authors.initials: DL
authors.lastname: Miller
authors.forename: I R
authors.initials: IR
authors.lastname: Horowitz
authors.forename: A E
authors.initials: AE
authors.lastname: Greenberg
authors.forename: W C
authors.initials: WC
authors.lastname: Reeves
mesh_terms: D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D007560:Cote d'Ivoire; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D015497:HIV-1 / Q000235:genetics; D015498:HIV-2 / Q000235:genetics; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications* / Q000276:immunology; D012307:Risk Factors; D011477:Sex Work; D014412:Tumor Virus Infections / Q000150:complications / Q000276:immunology; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000276:immunology / Q000821:virology*
chemical_list: D004279:DNA, Viral