Abstract
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. 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. 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. 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. 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.
Highlights
It is estimated that over one million women worldwide currently have cervical cancer, mostly undiagnosed
We examined the association between cervical intraepithelial neoplasia (CIN) and the presence of human immunodeficiency virus (HIV) and immunosuppressive status (T CD4+ lymphocytes < 500 cells/mm3), along with risk factors for CIN
CIN was found in 17 patients (26.6%) in the HIV-infected group and in five uninfected women (6.6%) (p = 0.01) (Table 3)
Summary
It is estimated that over one million women worldwide currently have cervical cancer, mostly undiagnosed. Over the past three decades, cervical cancer rates have fallen in most of the developed world, probably as a result of screening and treatment programs. Rates in developing countries have risen or remained unchanged. At least 274,000 women die from invasive cervical cancer, mainly in developing countries, where access to screening services is limited.[1]. Brazil has a continental size and marked regional inequalities. Cervical cancer is the third most common cancer among women in Bra-
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Schedule a callMore From: Sao Paulo medical journal = Revista paulista de medicina
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