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

Abstract

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.

HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country

“…The results from only one study in Cervical Intraepithelial Abnormalities (%) DOI:http://dx.doi.org/10.7314/APJCP.2015.16.18.8085 HPV Infection and Cervical Abnormalities in HIV Positive Women in Different Regions of Brazil, a Middle-Income Country the Northeast region were similar to the Southeast region, with a low prevalence of CIN. However, in this study, the frequency of CIN was higher in HIV+ (26.6%) women compared to HIV-women (6.6%), specifically those that did not use HAART, although this difference was not statistically significant (Oliveira et al, 2010). Overall, studies showed that the prevalence of HPV infection in HIV+ women is high, while that of CIN is low.…”

“…In these regions, HIV+ women are has better follow-up statistics and correctly use the HAART, which seems to protect against the development of cervical lesions (Rocha-Brischiliari et al, 2014). The prevalence of low-grade cervical abnormalities is common in younger patients (Kurman et al, 2011), which is in agreement with these studies once the median age of HIV+ and HIV-women was below 35 years old (Entiauspe et al, 2010;Oliveira et al, 2010;Andrade et al, 2011;Melgaco et al, 2011;.…”

“…Similar results were found in the Northeast, where in 25% of samples from HIV+ women cytological abnormalities were detected including LSIL (18.8%) and HSIL (6.2%). Although HIV-women also had LSIL and HSIL, the frequency was reduced (6.6% and 1.3%, respectively) (Oliveira et al, 2010). However, another study in the Southeast found no observed difference in the prevalence of abnormal cytological findings between HIV+ (23.0%) and HIV-(24.0%) women; HSIL was not found.…”

Association of antiretroviral therapy with high-risk human papillomavirus, cervical intraepithelial neoplasia, and invasive cervical cancer in women living with HIV: a systematic review and meta-analysis

“…One publication provided data from two countries, 17 and was considered as two individual studies in the analysis. 12 further studies reported the association of ART with the prevalence of combined cytology diagnosed outcomes of atypical squamous cells of undetermined significance (or higher), 42 , 43 , 44 , 45 , 46 , 47 , 48 and low-grade SIL (or higher), 49 histology diagnosed CIN (grade 1 or higher), 50 , 51 and abnormalities on visual inspection with colposcopy ( appendix p 20 ). 52 , 53 …”

Behavioral interventions to promote condom use among women living with HIV: a systematic review update

“…These challenges directly affect their sexual practices. Women living with HIV are at increased risk for sexually transmitted infections (STI) 4,5 , cervical dysplasia, and genital cancer 6,7 . Concurrent STI and HIV also increase the risk of female-to-male HIV transmission during sexual intercourse 5 and the risk of mother-to-child HIV transmission by pregnant women.…”