Effect of Low CD4 Cell Count on Cervical Squamous Intraepithelial Lesions among HIV-Positive Women in Enugu, Southeastern Nigeria

Enebe, Joseph Tochukwu; Dim, Cyril Chukwudi; Nnakenyi, Emeka Francis; Ezegwui, Hyginus U.; Ozumba, Benjamin C.

doi:10.7860/jcdr/2015/14808.6785

Cited by 3 publications

(4 citation statements)

References 22 publications

(2 reference statements)

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“… 40 Similarly, the relationship between low CD4 count with VIA positivity has been demonstrated in studies among WLWHIV in South Africa, 41 Tanzania, 42 and Nigeria. 43 …”

Section: Discussionmentioning

confidence: 99%

“…40 Similarly, the relationship between low CD4 count with VIA positivity has been demonstrated in studies among WLWHIV in South Africa, 41 Tanzania, 42 and Nigeria. 43 Our study period predates the WHO's adoption in 2020 of the global strategy to eliminate cervical cancer, 9 which many LMICs have since adopted. This 90/70/90 strategy calls for 70% CCS coverage of all eligible women globally at least twice in their lifetime by 2030, regardless of their HIV status.…”

Section: Discussionmentioning

confidence: 99%

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Real-World Cervical Cancer Screening Uptake and Predictors of Visual Inspection With Acetic Acid Positivity Among Women Living With HIV in Care Programs in Western Kenya

Mungo,

Orang'o,

Ofner

et al. 2024

JCO Glob Oncol

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PURPOSE To achieve the WHO cervical cancer elimination targets, countries globally must achieve 70% cervical cancer screening (CCS) coverage. We evaluated CCS uptake and predictors of screening positive at two public HIV care programs in western Kenya. METHODS From October 2007 to February 2019, data from the Family AIDS Care and Education Services (FACES) and Academic Model Providing Access to Healthcare (AMPATH) programs in western Kenya were analyzed. The study population included women age 18-65 years enrolled in HIV care. Screening uptake was calculated annually and overall, determining the proportion of eligible women screened. Multivariate logistic regression assessed predictors of positive screening outcomes. RESULTS There were 57,298 women living with HIV (WLWHIV) eligible for CCS across both programs during the study period. The mean age was 31.4 years (IQR, 25.9-37.8), and 39% were on antiretroviral therapy (ART) at the first CCS-eligible visit. Of all eligible women, 29.4% (95% CI, 29.1 to 29.8) underwent CCS during the study period, 27.0% (95% CI, 26.5 to 27.4) in the AMPATH program, and 35.6% (95% CI, 34.9 to 36.4) in the FACES program. Annual screening uptake varied greatly in both programs, with coverage as low as 1% of eligible WLWHIV during specific years. Age at first screening, CD4 count within 90 days of screening, current use of ART, and program (AMPATH v FACES) were each statistically significant predictors of positive screening. CONCLUSION CCS uptake at two large HIV care programs in Kenya fell short of the WHO's 70% screening target. Screening rates varied significantly on the basis of the availability of funding specific to CCS, reflecting the limitations of vertical funding programs.

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“… 40 Similarly, the relationship between low CD4 count with VIA positivity has been demonstrated in studies among WLWHIV in South Africa, 41 Tanzania, 42 and Nigeria. 43 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-World Cervical Cancer Screening Uptake and Predictors of Visual Inspection With Acetic Acid Positivity Among Women Living With HIV in Care Programs in Western Kenya

Mungo,

Orang'o,

Ofner

et al. 2024

JCO Glob Oncol

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“…Most participants in Chalermchockcharoenkit study have received HAART. Enebe et al 7 found that the prevalence of abnormal cervical cytology in HIV-infected women who had low CD4 (CD4 < 200 cells/µL) was 10.2% while those who had high CD4 (CD4 ≥ 200 cells/µL) was 5.7%. Moreover, the low CD4 group had higher prevalence of abnormal cervical cytology than the high CD4 group.…”

Section: Jsafogmentioning

confidence: 99%

“…However, Enebe et al 7 studied about the relationship between CD4 level and prevalence of abnormal cervical cytology in HAART experienced HIV-positive women. They found that the prevalence of abnormal cervical cytology in low CD4 group (CD4 < 200 cells/µL) was 10.2% and it was 5.7% in high CD4 group (CD4 ≥ 200 cells/µL), but no statistical significance.…”

Section: Introductionmentioning

confidence: 99%

Effects of CD4 Level on Abnormal Cervical Cytology in HAART-naïve HIV-seropositive Women

Neamtan¹,

Noothong²,

Pulsawat³

2018

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim: To study the effects of cluster of differentiation 4 (CD4) level on abnormal cervical cytology in human immunodeficiency virus (HIV)-infected women who have not received highly active antiretroviral therapy (HAART). Materials and methods:Retrospective cross-sectional study was carried at Hatyai Hospital from October 1, 2010 to June 30, 2016. Medical records of 270 HIV-infected women who have not received HAART and have been screened for cervical cancer with Pap smear were reviewed. The CD4 level has been evaluated in all patients. Participants were divided into two groups: 135 patients with CD4 < 200 cells/µL (low CD4 group) and 135 patients with CD4 at least 200 cells/µL (high CD4 group). Statistical analysis was performed. Results:The prevalence of abnormal cervical cytology in HIVinfected women who have not received HAART was 25.9%. There was difference in prevalence of abnormal cervical cytology between low and high CD4 groups (37.8 vs 17.0%) with statistical significance (p = 0.001). Odds ratio was 2.60 (95% confidence interval: 1.47-4.61). Conclusion:The low CD4 level (CD4 < 200 cells/µL) in HIVinfected women who did not receive HAART increased risk of abnormal cytology of 2.6 folds, compared with high CD4 level (CD4 at least 200 cells/µL). The prevalence of abnormal cervical cyto logy in HIV-infected women who have not received HAART was 25.9%. Clinical significance:Human immunodeficiency virus infection is the significant risk factor of cervical cancer. The authors evaluated the effects of CD4 level on abnormal cervical cytology in women who have not received HAART.

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Prevalence and predictors of squamous intraepithelial lesions in human immunodeficiency virus positive women in Sagamu, southwest Nigeria

Ogunsowo

Akadri

Odelola

et al. 2022

J. Public Health Afr.

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Background: Cervical cancer is still a public health problem in many developing countries, like Nigeria. HIV infection makes HPV infections last longer, progress to squamous intraepithelial lesion of the cervix, and eventually lead to invasive cervical cancer. Objective. Find out how often squamous intraepithelial lesions (SIL) happen and what causes them in HIV-positive women in Sagamu, southwest Nigeria. Methods. A cross-sectional study was done with 165 women with HIV and 165 women without HIV. Pap smears were done on all of the people in the study. The data was looked at with IBM-SPSS Windows v. 23. Results: Both groups were about the same age and had the same number of children (P=0.194 and P=0.388, respectively). The participants’ average age (SD) was 36.8 (5.6), and the median number of children they had was 3. HIV-positive women were much more likely to have an abnormal cytology smear (24.8%) than HIV-negative women (7.3%) (2 = 18.904, P 0.001). There wasn’t a link between having HIV and the severity of cervical lesions (2 = 3.66, P = 0.162). A CD4 cell count of less than 350 cells/mm3was found to be a strong predictor of an abnormal cervical cytological smear in HIV-positive women (AOR: 25.5; CI: 8.8-73.5; P 0.001). Conclusion. In Sagamu, Nigeria, the number of HIV-positive women with SIL of the cervix was much higher than the number of HIVnegative women with SIL of the cervix. HIV-positive women, especially those with a low number of CD4 cells, need cervical smear tests more often. This will make sure that pre-invasive lesions are found and treated as soon as possible.

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Effect of Low CD4 Cell Count on Cervical Squamous Intraepithelial Lesions among HIV-Positive Women in Enugu, Southeastern Nigeria

Cited by 3 publications

References 22 publications

Real-World Cervical Cancer Screening Uptake and Predictors of Visual Inspection With Acetic Acid Positivity Among Women Living With HIV in Care Programs in Western Kenya

Real-World Cervical Cancer Screening Uptake and Predictors of Visual Inspection With Acetic Acid Positivity Among Women Living With HIV in Care Programs in Western Kenya

Effects of CD4 Level on Abnormal Cervical Cytology in HAART-naïve HIV-seropositive Women

Prevalence and predictors of squamous intraepithelial lesions in human immunodeficiency virus positive women in Sagamu, southwest Nigeria

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