title: Evolution of cervical cytologic changes among HIV-infected women with normal cytology in the HAART era.
abstract: The influence of HAART on the evolution to cervical squamous intraepithelial lesions (SIL) among HIV(+) women with a normal cytological test in the HAART era was studied. A retrospective cohort study (1997-2005) of HIV-infected women treated with HAART was conducted. Those with a normal cervical cytology (Papanicolaou test) and at least one subsequent test were included. Survival (time until diagnosis of SIL), univariate, and multivariate analyses were performed. A total of 133 HIV-infected patients treated with HAART were included. The incidence of SIL was 35% (47 patients). SIL was diagnosed in 36 of 110 (33%) patients with a baseline and final immunological status of >200 CD4 cells/microl and in 6 of 9 (67%) patients with a baseline and final immunological status of < or =200 CD4 (OR: 0.24, 95% CI: 0.06-1.03, p = 0.041). SIL was diagnosed in 10 of 60 (17%) patients with an undetectable baseline and final HIV viral load and in 36 of 70 (51%) patients with a detectable HIV viral load (OR: 0.19, 95% CI: 0.07-0.46, p < 0.001). A high incidence of SIL (cancer precursor lesions) was observed among HIV(+) women without a background of cervical pathology. The effect of HAART on the control of HIV replication and of immunological status (>200 CD4) through the follow-up was associated with a reduction of SIL.
authors.affiliation: Department of Medicine, University Hospital Germans Trias i Pujol, Badalona (Barcelona )08916, Spain.
authors.forename: Guillem
authors.initials: G
authors.lastname: Sirera
authors.forename: Sebastià
authors.initials: S
authors.lastname: Videla
authors.forename: Raquel
authors.initials: R
authors.lastname: López-Blázquez
authors.forename: Mariona
authors.initials: M
authors.lastname: Llatjos
authors.forename: Antoni
authors.initials: A
authors.lastname: Tarrats
authors.forename: Eva
authors.initials: E
authors.lastname: Castellà
authors.forename: Nuria
authors.initials: N
authors.lastname: Grane
authors.forename: Carmen
authors.initials: C
authors.lastname: Alcalde
authors.forename: Cristina
authors.initials: C
authors.lastname: Tural
authors.forename: Celestino
authors.initials: C
authors.lastname: Rey-Joly
authors.forename: Bonaventura
authors.initials: B
authors.lastname: Clotet
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002584:Cervix Uteri / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006678:HIV / Q000502:physiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D065006:Papanicolaou Test; D012189:Retrospective Studies; D014626:Vaginal Smears; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000821:virology