Prevalence and risk factors for cervical intraepithelial neoplasia in HIV-infected women in Salvador, Bahia, Brazil.
OBJECTIVE
The human immunodeficiency virus (HIV) is frequently associated with high-grade intraepithelial neoplasia. Immunosuppression and high HIV viral load are the main risk factors for cervical intraepithelial neoplasia (CIN). The aim of this study was to determine the prevalence of CIN in HIV-infected women in Salvador, Bahia, Brazil, and to describe the risk factors in comparison with non-infected women.


METHODS
Cross-sectional study at the AIDS Reference Center of Bahia and the Gynecological Outpatient Clinic of Fundação Bahiana para o Desenvolvimento da Ciência, in Salvador, Bahia, Brazil.


METHODS
Sixty-four HIV-infected women and 76 uninfected women from Salvador were enrolled between May 2006 and May 2007. Associations between CIN and presence of HIV infection, HIV viral load, proportion of T CD4+ lymphocytes and risk factors were evaluated. The independence of the risk factors was investigated using logistic regression.


RESULTS
CIN was more prevalent among HIV-infected women than in the control group (26.6% versus 6.6%; P = 0.01). The odds ratio for CIN among HIV-infected women was 3.7 (95% confidence interval, CI: 1.23-11; P = 0.01), after adjusting for the following variables: age at first sexual intercourse, number of partners, number of deliveries and previous history of sexually transmitted disease.


CONCLUSIONS
The prevalence of CIN among HIV-infected women was significantly higher than among women without HIV infection. HIV infection was the most important risk factor associated with the development of cervical lesions.
Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil.
Paula Matos
PM
Oliveira
Rone Peterson Cerqueira
RP
Oliveira
Iane Érica Martins
IÉ
Travessa
Marques Vinícius de Castro
MV
Gomes
Maria Lícia de Jesus Dos
ML
Santos
Maria Fernanda Rios
MF
Grassi
D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000276:immunology; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D019562:Viral Load; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000209:etiology*