title: High-risk human papillomavirus and cervical lesions among women living with HIV/AIDS in Brazilian Amazon, Brazil.
abstract: OBJECTIVE
  The goal of this study was to determine the prevalence of human papillomavirus infection infection and cervical lesions and its associated factors among HIV infected women attending an AIDS clinic in Amazonas state, Brazil.
  
  
  METHODS
  Cross-sectional study. Women attending an AIDS clinic in the city of Manaus between March and December 2011 for gynecological examination were invited to participate. Enrolled patients answered a standardized interview including demographical, behavioral, and clinical data. Additionally, patients underwent a gynecological evaluation with collection of cervical samples for cytological analysis and high-risk human papillomavirus infection hybrid capture. A blood sample was also obtained to determine CD4 and viral load levels.
  
  
  RESULTS
  A total of 310 (82.9%) women participated in the study. High-risk human papillomavirus infection was detected in 191 (61.6%) cases; 24 (13.5%) had low-grade squamous intraepithelial lesion (SIL) and 4 (2.2%) high-grade SIL. No invasive cervical cancer was diagnosed. Median age was 32 (interquartile range (IQR): 27-38) years and median of education was 8.5 (IQR 4-11) years of schooling and 56.1% had a monthly income up to US$180. In multivariate analysis, being less than 30 years old [OR=1.7 (95% CI: 1.2-2.4, p=0.005)], high-grade SIL [OR=6.5 (95% CI: 1.6-23.0, p=0.009)], and CD4 counts <200cells/mm(3) [OR=1.6 (95% CI: 1.2-2.0, p<0.001)] were associated with high risk human papillomavirus infection infection.
  
  
  CONCLUSIONS
  In the present study high-risk human papillomavirus infection was frequent and it was associated to high-SIL. These results show the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.
authors.affiliation: Fundação de Vigilância em Saúde do Amazonas, Manaus, AM, Brazil; Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil; Faculdade de Medicina, Universidade Nilton Lins, Manaus, AM, Brazil. Electronic address: leilac1994@gmail.com.
authors.forename: Leila da
authors.initials: Ld
authors.lastname: Silva
authors.affiliation: Post Graduation Program in Tropical Medicine, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado/ Universidade do Estado do Amazonas, Manaus, AM, Brazil; Infectious Diseases Unit, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil.
authors.forename: Angélica
authors.initials: A
authors.lastname: Miranda
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Rosieny
authors.initials: R
authors.lastname: Batalha
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil; Post Graduation Program in Tropical Medicine, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado/ Universidade do Estado do Amazonas, Manaus, AM, Brazil.
authors.forename: Luiz
authors.initials: L
authors.lastname: Ferreira
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil.
authors.forename: Mayara
authors.initials: M
authors.lastname: Santos
authors.affiliation: Post Graduation Program in Tropical Medicine, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado/ Universidade do Estado do Amazonas, Manaus, AM, Brazil.
authors.forename: Sinésio
authors.initials: S
authors.lastname: Talhari
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology*; D011230:Precancerous Conditions / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D019562:Viral Load; D055815:Young Adult
chemical_list: D004279:DNA, Viral
keywords: Brazilian Amazon; Cervical cancer; HIV; HPV