title: Incidence of cervical intraepithelial neoplasia in a cohort of HIV-infected women.
abstract: OBJECTIVE
  To assess cervical intraepithelial neoplasia (CIN) incidence in HIV-positive women and the risk factors for these lesions.
  
  
  METHODS
  A retrospective and longitudinal cohort study was conducted from June 13, 1997, to December 18, 2009. At the first visit, the 348 participants had a normal cytologic finding but a negative Schiller test result, or an abnormal cytologic finding but no histologic diagnosis of CIN. Infection with HPV was detected by polymerase chain reaction. The main outcome measure was CIN incidence.
  
  
  RESULTS
  During a mean follow-up of 40 months, 47 women (13.5%) developed CIN, for an incidence of 4.1 cases per 100 person-years of follow-up. The HPV prevalence was 68.1%, 42 women (89.4%) developed CIN 1, and no invasive cervical cancers were identified. On multivariate analysis, women younger than 19 years at first sexual intercourse (RR, 2.6; 95% CI, 1.24-5.35) and women who had never used antiretrovirals or used them only during pregnancy (RR, 2.3; 95% CI, 1.31-4.19) were at higher risk for CIN.
  
  
  CONCLUSIONS
  The CIN incidence was low despite the high HPV prevalence. Being younger than 19 years at first sexual intercourse and not using antiretroviral medications were found to be the main risk factors for CIN.
authors.affiliation: Department of Health Services, Belo Horizonte, Brazil.
authors.forename: Angela C L
authors.initials: AC
authors.lastname: Araújo
authors.forename: Nara O
authors.initials: NO
authors.lastname: Carvalho
authors.forename: Nara C
authors.initials: NC
authors.lastname: Teixeira
authors.forename: Tatiana T
authors.initials: TT
authors.lastname: Souza
authors.forename: Erica D
authors.initials: ED
authors.lastname: Murta
authors.forename: Iwens M
authors.initials: IM
authors.lastname: Faria
authors.forename: Christine M
authors.initials: CM
authors.lastname: Corrêa
authors.forename: Maria I M
authors.initials: MI
authors.lastname: Lima
authors.forename: Dora M
authors.initials: DM
authors.lastname: Del Castillo
authors.forename: Victor H
authors.initials: VH
authors.lastname: Melo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003075:Coitus; D005260:Female; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology*
chemical_list: D044966:Anti-Retroviral Agents