Incidence of Cervical Human Papillomavirus and Cervical Intraepithelial Neoplasia in Women with Positive and Negative HIV Status.
Objectives To evaluate the incidence and factors associated with cervical intraepithelial neoplasia (CIN) and cervical infection by human papillomavirus (HPV) among HIV-positive and HIV-negative women. Methods A cohort of 103 HIV positive and 113 HIV negative women were monitored between October 2008 and February 2012, for at least one year. Procedures included cervical cytology, DNA/HPV detection by polymerase chain reaction, colposcopy with biopsy if necessary, followed by an interview for exposure characteristics data. CIN was based on the histopathological results. Results The incidence of CIN was of 8.8 and 4.6 cases/100 women-years in HIV-positive and HIV-negative women, respectively. HIV-positive women presented a hazard ratio (HR) of 2.8 for CIN and developed lesions earlier (0.86 year) than HIV-negative women (2 years) (p = 0.01). The risk of developing CIN decreased with age (HR = 0.9) and marital status (HR = 0.4). HPV patients presented a higher incidence of CIN when compared HIV-positive and HIV-negative women (p = 0.01). The incidence of HPV cervical infection was 18.1 and 11.4 cases/100 women-years in HIV-positive and HIV-negative women, respectively. Those HIV-positive presented earlier HPV infection(p = 0.002). The risk of developing HPV infection decreased with age and was higher among HIV-positive women. HPV 16 was the most common type in HIV-positive women, and also the type most closely associated with CIN in HIV-negative women. Conclusions HIV-positive women had a greater incidence of HPV and CIN, and in a shorter time interval. More rigorous and timely clinical control is required for this group.
Department of Gynecology and Obstetrics, Faculdade de Ciencias Médicas de Minas Gerais - FCCMG, Belo Horizonte, Minas Gerais, Brazil.
Benito Pio Vitorio
BP
Ceccato Junior
Department of Preventive and Social Medicine, Faculdade de Medicina, UFMG, Belo Horizonte, Minas Gerais, Brazil.
Mark Drew Crosland
MD
Guimarães
Faculdade de Medicina de Barbacena, Barbacena, Minas Gerais, Brazil.
Ana Paula Ceccato
AP
Lopes
Faculdade de Ciencias Médicas de Minas Gerais - FCCMG, Belo Horizonte, Minas Gerais, Brazil.
Lorena Fiorini
LF
Nascimento
Faculdade de Medicina de Barbacena, Barbacena, Minas Gerais, Brazil.
Luísa Magalhães
LM
Novaes
Center for Action and Research in Support Diagnostics, UFMG, Belo Horizonte, Minas Gerais, Brazil.
Dora Méndez
DM
Del Castillo
Department of Gynecology and Obstetrics, Faculdade de Medicina, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, Minas Gerais, Brazil.
Victor Hugo
VH
Melo
D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D015994:Incidence; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000821:virology*