title: Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women.
abstract: OBJECTIVE
  To evaluate the prevalence and the risk factors for cervical intraepithelial neoplasia (CIN) among HIV-infected women.
  
  
  METHODS
  Cross-sectional study of 494 HIV-infected women in Brazil, between 1998 and 2008. Gynecologic exam was performed, and samples were collected for cervical cytology and for HPV DNA detection. Cervical biopsy was carried out when indicated. HPV infection, CD4 T-lymphocyte count and HIV viral load were compared with cervical histopathology. Univariate and multivariate statistical analyses were performed to evaluate the statistical association of several risk factors.
  
  
  RESULTS
  CIN prevalence detected by histopathology was 23.4% (6% of CIN2/3 and 17.4% cases of CIN1). Multivariate analysis confirmed an independent association of CIN with CD4 T-lymphocyte count below 200 cells/mm³ (OR 5.0, 95% CI 2.5-10.1), with a positive detection of HPV DNA (OR 2.0, 95% CI 1.2-3.5), and with age < 34 years old (OR 1.5, 95% CI 1.0-2.4). HIV viral load and antiretroviral use were not independent risk factors for CIN.
  
  
  CONCLUSIONS
  Severity of immunosuppression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infected women.
authors.affiliation: Department of Health Services, Belo Horizonte, MG, Brazil.
authors.forename: Nara Chartuni Pereira
authors.initials: NC
authors.lastname: Teixeira
authors.forename: Angela Cristina Labanca
authors.initials: AC
authors.lastname: Araújo
authors.forename: Christine Miranda
authors.initials: CM
authors.lastname: Correa
authors.forename: Claudia Teixeira da Costa
authors.initials: CT
authors.lastname: Lodi
authors.forename: Maria Inês Miranda
authors.initials: MI
authors.lastname: Lima
authors.forename: Nara de Oliveira
authors.initials: Nde O
authors.lastname: Carvalho
authors.forename: Dora Mendez Del
authors.initials: DM
authors.lastname: Castillo
authors.forename: Victor Hugo
authors.initials: VH
authors.lastname: Melo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004279:DNA, Viral; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D014626:Vaginal Smears; D019562:Viral Load; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology
chemical_list: D004279:DNA, Viral