Increased risk of high-grade cervical squamous intraepithelial lesions and invasive cervical cancer among African women with human immunodeficiency virus type 1 and 2 infections.
To assess the risk of prevalent high-grade cervical squamous intraepithelial lesions (HSILs) or invasive cervical cancer (ICC) associated with human immunodeficiency virus (HIV) type 1, HIV-2, and human papillomavirus (HPV) infections, HIV load, and CD4 cell count, we studied 4119 women attending an outpatient clinic in Senegal. HIV infection was associated with increased rates of cervical infection with high-risk HPVs. Among women infected with high-risk HPVs, those with HIV-1 (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.0-4.8), HIV-2 (OR, 6.0; 95% CI, 2.1-17.1), or dual HIV infection (OR, 8.0; 95% CI, 2.0-31.5) were more likely to have HSILs or ICC diagnosed than were HIV-negative women; this association was not observed among women not infected with high-risk HPVs. Among women with HIV, higher HIV plasma RNA loads and lower CD4 cell counts were associated with high-risk HPV infection and degree of cervical abnormality. Furthermore, HIV-2-positive women were more likely to have HSILs (OR, 3.3; 95% CI, 0.9-12.4) or ICC (OR, 7.9; 95% CI, 1.1-57) than were HIV-1-positive women.
Hawes
Stephen E
SE
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, US. hawes@u.washington.edu.
Critchlow
Cathy W
CW
Faye Niang
Mame A
MA
Diouf
Mame B
MB
Diop
Aissatou
A
Touré
Papa
P
Aziz Kasse
Abdoul
A
Dembele
Birama
B
Salif Sow
Papa
P
Coll-Seck
Awa M
AM
Kuypers
Jane M
JM
Kiviat
Nancy B
NB
D017088:AIDS-Related Opportunistic Infections / Q000473:pathology; D000328:Adult; D018791:CD4 Lymphocyte Count; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000473:pathology*; D002488:Central African Republic / Q000453:epidemiology; D002584:Cervix Uteri / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D015497:HIV-1 / Q000502:physiology*; D015498:HIV-2 / Q000502:physiology*; D006801:Humans; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications / Q000473:pathology; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000150:complications / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000473:pathology*; D019562:Viral Load
D012367:RNA, Viral