Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV

Zimmermmann, Juliana Barroso; Melo, Victor Hugo; Castro, Lúcia Porto Fonseca de; Alves, Márcio José Martins; Zimmermmann, Sebastião Guerra; Castillo, Dora Méndez del

doi:10.1590/s0100-72032006000600005

Cited by 10 publications

(11 citation statements)

References 26 publications

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“…This finding is in accordance with other studies that did not find any association between the T CD4+ lymphocyte count and the severity of CIN. 22,23 Nevertheless, the majority of the HIV-infected patients enrolled in the present study were being treated with HAART and their cell immune response was preserved, with T CD4+ cell counts higher than 500 cells/mm 3 . However, the immune response against HPV also depends on innate immunity, including macrophages, natural killer cells and cytokine production, which may also be impaired during HIV infection.…”

Section: Discussionmentioning

confidence: 87%

Prevalence and risk factors for cervical intraepithelial neoplasia in HIV-infected women in Salvador, Bahia, Brazil

Oliveira

Travessa

et al. 2010

Sao Paulo Med. J.

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CONTEXT AND OBJECTIVE: 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. RESULTS: 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. CONCLUSION: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.RESUMO CONTEXTO E OBJETIVO: O vírus da imunodeficiência humana (HIV) está frequentemente associado à neoplasia intraepitelial de alto grau.Imunossupressão e carga viral do HIV elevada são os principais fatores de risco para neoplasia intra-epitelial cervical (NIC). O objetivo deste estudo foi determinar a prevalência de NIC em mulheres infectadas pelo HIV, em Salvador, Bahia, Brasil e descrever os fatores de risco, comparando-as com mulheres não infectadas.

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Section: Discussionmentioning

confidence: 87%

Prevalence and risk factors for cervical intraepithelial neoplasia in HIV-infected women in Salvador, Bahia, Brazil

Oliveira

Travessa

et al. 2010

Sao Paulo Med. J.

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“…Immunosuppression resulting from HIV increases the risk of developing squamous intraepithelial lesions when compared with the general population [ 7 – 10 ]. Patients more severely immunocompromised as a result of HIV infection might have a higher incidence and persistence of lesions caused by HPV [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

High risk human papillomavirus prevalence and genotype distribution among women infected with HIV in Manaus, Amazonas

Teixeira

Sabidó

Leturiondo

et al. 2018

Virol J

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BackgroundHuman immunodeficiency virus (HIV)-positive women have a high prevalence of human papillomavirus (HPV), and are infected with a broader range of HPV types than HIV-negative women. We aimed to determine the prevalence of cervical cytologic abnormalities, high-risk (HR)-HPV prevalence, type distribution according to the severity of cervical lesions and CD4 cell count and identify factors associated with HR-HPV infection among women living with HIV in Manaus, Amazonas.MethodsWe enrolled 325 women living with HIV that attended an infectious diseases referral hospital. Each woman underwent a gynecological exam, cervical cytology, HR-HPV detection by Polymerase chain Reaction (PCR) using the BD Onclarity™ HPV Assay, colposcopy and biopsy, when necessary. We assessed the associations between potential risk factors and HR-HPV infection.ResultsOverall, 299 (92.0%) women had a PCR result. The prevalence of HR-HPV- infection was 31.1%. The most prevalent HR-HPV types were: 56/59/66 (32.2%), 35/39/68 (28.0%), 52 (21.5%), 16 (19.4%), and 45 (12.9%). Among the women with HR-HPV infection (n = 93), 43.0% had multiple infections. Women with HPV infection showed higher prevalence of cervical abnormalities than that HPV-negative (LSIL: 22.6% vs. 1.5%; HSIL: 10.8% vs. 0.0%). The prevalence of HR-HPV among women with cytological abnormalities was 87.5% for LSIL and 100.0% for HSIL. Women with CD4 < 200 cell/mm3 showed the highest HR-HPV prevalence (59.3%) although this trend was not statistically significant (p-value = 0.62). The mean CD4 cell count decreased with increasing severity of cervical lesions (p-value = 0.001). The multivariable analysis showed that increasing age was associated with a decreased risk of HR-HPV infection with an adjusted prevalence odds ratio of 0.9 (95.0% CI: 0.9–1.0, p-value: 0.03) for each additional year. The only factor statistically significant associated with HR-HPV infection was CD4 cell count.ConclusionsHR-HPV and abnormal cytology prevalence are high among women in the Amazonas. The low CD4 cell count was an important determinant of HPV infection and abnormal cytological findings. HPV quadrivalent vaccination used in Brazil might not offer protection for an important fraction of HPV-related disease burden in women living with HIV. This is partly explained by the high presence of non targeted vaccine HR-HPVs, such as the HPV genotype groups 56/59/66, 35/39/68 and individually HPV-52 and HPV-45, some of which contribute to high-grade lesion.Electronic supplementary materialThe online version of this article (10.1186/s12985-018-0942-6) contains supplementary material, which is available to authorized users.

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“…Essa tendência não se confirmou com a aplicação de testes estatísticos, possivelmente porque há reduzido contingente de indivíduos participantes da amostra. Por outro lado, Zimmermmann et al 7 não encontraram associação entre os níveis de CD4+ e a ocorrência de neoplasia intraepitelial de baixo ou alto grau; os autores sugerem que isso pode ter ocorrido porque a resposta imunológica é muito complexa, e não deve ser avaliada apenas pela contagem de linfócitos CD4+. Ao analisar seus resultados, os autores relataram que o uso do tratamento antirretroviral poderia ter papel de interferência na evolução da expressão do HPV, contribuindo para seus achados.…”

Section: Discussionunclassified

“…A instabilidade cromossômica, na aneuploidia seria um dos principais eventos associados ao processo carcinogenético 4 . A possível ação genotóxica do HPV e a incapacidade em depurar de maneira satisfatória o vírus podem ser caracterizadas clinicamente pela maior prevalência de alguns tipos específicos de tumores na população com comprometimento imunitário [5][6][7] . Estudos propõem que a lesão do genoma de indivíduos soropositivos para o vírus da imunodeficiência humana adquirida (HIV) poderia estar associada ao gene Vpr, um gene acessório do HIV-1 e HIV-2, com capacidade de induzir anormalidades no ciclo celular durante o período G2, promovendo, assim, instabilidade genômica [8][9][10] .…”

Section: Introductionunclassified

Micronúcleos em células do colo uterino em mulheres HIV+ segundo sua condição de imunidade

Mendes¹,

Filho²,

Furoni³

et al. 2011

Rev. Bras. Ginecol. Obstet.

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PURPOSE: to investigate the micronucleation (MN) of exfoliated cells from the uterine cervix of HIV+ women according to immunocompetence status. We investigated the clinical conditions of immunocompetence by analyzing the levels of CD4+ lymphocytes and viral count for HIV (VC). METHODS: biological material was collected from 23 HIV+ patients whose cervical oncologic cytology results were negative. They were patients from the STD/AIDS-FCMS-PUCSP who underwent a cytobrush collection in the squamous columnar junction. Similar material was obtained from 19 healthy control women. The material, about 2000 cells per patient, was processed for cytology using light microscopy and an immersion objective. To analyze the immunological status of HIV+ patients we used CD4+ count and VC. Statistical analysis was performed using the χ 2 and Kolmorogov-Smirnov tests. RESULTS: twenty-three pacients composed the group of HIV+ women and 19 composed the control group. We found micronuclei (MN) in all HIV+ patients and in 84.2% of the control group. In 17 73.9% of the HIV+ patients and in 5.2% of the control group we found more than 7 MN cells. MN tended to occur more among women with poorer immunological status in the HIV+ group. CONCLUSIONS: HIV+ patients in the AIDS phase have a higher prevalence of micronucleated cells, as opposed to a control group. Also, the frequency of MN was associated with worse conditions of immunosuppression.

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Associação entre a contagem de linfócitos T CD4+ e a gravidade da neoplasia intra-epitelial cervical diagnosticada pela histopatologia em mulheres infectadas pelo HIV

Cited by 10 publications

References 26 publications

Prevalence and risk factors for cervical intraepithelial neoplasia in HIV-infected women in Salvador, Bahia, Brazil

Prevalence and risk factors for cervical intraepithelial neoplasia in HIV-infected women in Salvador, Bahia, Brazil

High risk human papillomavirus prevalence and genotype distribution among women infected with HIV in Manaus, Amazonas

Micronúcleos em células do colo uterino em mulheres HIV+ segundo sua condição de imunidade

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