HPV, HIV Infection, and Risk of Cervical Intraepithelial Neoplasia in Former Intravenous Drug Abusers

Conti, M.; Agarossi, Alberto; Parazzini, Fabio; Muggiasca, M.L.; Boschini, Antonio; Negri, Eva; Casolati, Elena

doi:10.1006/gyno.1993.1137

Cited by 68 publications

(25 citation statements)

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“…The prevalence of SIL among our HIV‐infected patients was 49.4%, and this figure is slightly higher than that previously reported by other Italian investigators—42.1% by Conti et al [20] and 35.5% by Cappiello et al [8]. In our study population, HGSIL prevalence in relation to CD4+ cell counts was significantly higher among women with <500 CD4+ cells/mm 3 ( p = .02), but no significant difference emerged in relation to viral load as it occurred in 22.7% (5 of 22) of women with> 100,000 copies/mL and in 18.2% (20 of 110) of those with <100,000 copies/mL.…”

Section: Discussioncontrasting

confidence: 70%

Genital Human Papillomavirus Types in Immunocompetent and Immunodepressed Women in Northeast Italy: Prevalence and Cytomorphological Correlations

Mistro

Bonaldi

Bertorelle

et al. 2001

J Low Genital Tract Dis

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H uman papillomaviruses (HPVs) are etiologically related to the development of cervical cancer [1] and the large majority of the squamous cell abnormalities that precede squamous cell carcinoma of the cervix [2]. More than 80 different HPV types exist; 35-40 types infect the anogenital area. The relative risk associations of 15 common anogenital types, in which types 6/11, 42, 43, and 44 were defined as "low risk," types 31, 33, 35, 51, 52, and 58 as "intermediate risk," and types 16, 18, 45, and 56 as "high risk," show that the presence of an oncogenic HPV type confers a higher rel-Abstract Objective. We evaluated the prevalence of genital human papillomavirus (HPV) types in correlation with cytomorphological findings in patients at different risk for cervical intraepithelial neoplasia living in northeast Italy.Methods. Exfoliated cervicovaginal cells from 943 women, who were divided into three groups, were analyzed by polymerase chain reaction.Results. Overall, HPV prevalence rates were 7%, 38%, and 52%, respectively. The single most frequent type was HPV 16 (18%), followed by types 6, 31, 53, 58, 61, and novel/unidentified (5-7%); other types had a frequency Ͻ 5%. Infection with multiple types was present in 12%. In HIV-infected women, HPV infection was correlated with lower CD4 level and higher viral load; HGSILs were correlated only with a lower CD4 count, and no correlations were found for LGSILs.Conclusions. HGSILs were associated with high-risk types, mainly HPV 16 (40%). LGSILs, instead, were associated with a broad spectrum of low-risk and high-risk types.

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Section: Discussioncontrasting

confidence: 70%

Genital Human Papillomavirus Types in Immunocompetent and Immunodepressed Women in Northeast Italy: Prevalence and Cytomorphological Correlations

Mistro

Bonaldi

Bertorelle

et al. 2001

J Low Genital Tract Dis

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“…Given that invasive cervical cancer is preceded by gradual progression of premalignant CIN, 41-44 our findings highlight the importance of cervical screening upon entry into care to optimize the potential for early interventions and cure. This is essential among WLWH, given the higher prevalence of CIN 11,13 and the worse treatment outcomes among this population compared with HIV-negative women. 45-47 …”

Section: Discussionmentioning

confidence: 99%

“…This is because of the synergistic effects of a nation that is heavily burdened with HIV 6,7 and poor access to adequate diagnostic screening for precancerous lesions. 8-10 Women living with HIV (WLWH) have been shown to be at increased susceptibility for the development of precancerous lesions, 11-13 including both high-grade squamous intraepithelial lesions (HSILs) and cervical intraepithelial neoplasia (CIN), 14-16 and cervical cancer. 13,17-20 Unfortunately, most do not receive adequate screening, 21-24 despite recommendations made in 2014 that promote annual screening among WLWH.…”

Section: Introductionmentioning

confidence: 99%

Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates

Katz

Butler

Crankshaw

et al. 2016

JGO

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PurposeTo determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa.Materials and MethodsWe performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for < 3 months were excluded. Data were abstracted from electronic records and paper charts to assess rates of cervical abnormalities detected on Pap smears as well as time to colposcopy.ResultsDuring the study period, 432 women (93.5%) had at least one evaluable Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively.ConclusionIn a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival.

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“…For women living with HIV, the accuracy of cytology and colposcopy are critical to the timely diagnosis and treatment of cervical precancer as part of cancer prevention efforts. Rates of cervical intraepithelial neoplasia (CIN) are higher among those infected with HIV than among uninfected women [1, 2, 3, 4, 5]. The prevalence of abnormal cytology among HIV‐seropositive women is 38%[6], and current guidelines suggest intensive cytologic screening for women with HIV [7].…”

Section: Introductionmentioning

confidence: 99%

Correlating Papanicolaou Smear, Colposcopic Impression, and Biopsy: Results from the Women' s Interagency HIV Study

Massad

Schneider

Watts³

et al. 2001

J Low Genital Tract Dis

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HPV, HIV Infection, and Risk of Cervical Intraepithelial Neoplasia in Former Intravenous Drug Abusers

Cited by 68 publications

References 0 publications

Genital Human Papillomavirus Types in Immunocompetent and Immunodepressed Women in Northeast Italy: Prevalence and Cytomorphological Correlations

Genital Human Papillomavirus Types in Immunocompetent and Immunodepressed Women in Northeast Italy: Prevalence and Cytomorphological Correlations

Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates

Correlating Papanicolaou Smear, Colposcopic Impression, and Biopsy: Results from the Women' s Interagency HIV Study

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