Prevalence and risk factors of cervical squamous intraepithelial lesions among HIV-infected women in Dar es Salaam, Tanzania

Liu, Enju; McCree, Renicha; Mtisi, Expeditho; Fawzi, Wafaie W.; Aris, Eric; Lema, Irene Andrew; Hertzmark, Ellen; Chalamilla, Guerino; Li, Nan; Vermund, Sten H.; Spiegelman, Donna

doi:10.1177/0956462415584466

Cited by 14 publications

(23 citation statements)

References 27 publications

(37 reference statements)

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“…However, the finding is in contrast to the reports of Liu et al (2016) in Tanzanian and Ononogbu et al (2013) in Abuja, Nigeria who found a significant association between increasing age and the risk of developing premalignant lesions of the cervix among the women.…”

Section: Discussioncontrasting

confidence: 56%

“…But in contrast, Liu et al (2016) in their study of 1365 Tanzanian HIV positive women who had cervical cancer screening, reported that age more than 50 years was significantly associated with the occurrence of cervical cytological abnormalities. Similarly, Ononogbu et al (2013) studied 2501 HIV positive women in Abuja, Nigeria and reported that increasing age and age >40 years were associated with reduced risk of developing premalignant lesions of the cervix among the women.…”

Section: Introductionmentioning

confidence: 90%

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Sociodemographic determinants of abnormal cervical cytology among HIV positive women in Nnewi, Nigeria

Ugboaja¹,

Oguejiofor²,

Anya³

2017

Int. J. Med. Med. Sci.

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Women living with human immunodeficiency virus (HIV) infection have a higher burden of premalignant.7, p=0.03) and the Anglicans ( 2 =6.7, p=0.04). The prevalence rate was also the highest among women who were para 0-1 (36.6%), unemployed (100.0%), with no formal education (33.3%), and those who were separated from their husbands (100.0%), but these were not statistically significant. The prevalence of cervical cytological abnormalities among the HIV positive women attending the HIV clinic in NAUTH was high. Younger age, being a trader and Anglican Christian denomination were significantly associated with increased risk of premalignant lesions of the cervix.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 90%

Sociodemographic determinants of abnormal cervical cytology among HIV positive women in Nnewi, Nigeria

Ugboaja¹,

Oguejiofor²,

Anya³

2017

Int. J. Med. Med. Sci.

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“…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 …”

Section: Resultsmentioning

confidence: 99%

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

et al. 2018

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SummaryBackgroundThe interactions between antiretroviral therapy (ART) and high-risk human papillomavirus (HPV) and cervical lesions in women living with HIV are poorly understood. We reviewed the association of ART with these outcomes.MethodsWe did a systematic review and meta-analysis by searching MEDLINE and Embase databases for cross-sectional or cohort studies published in English between Jan 1, 1996, and May 6, 2017, which reported the association of ART with prevalence of high-risk HPV or prevalence, incidence, progression, or regression of histological or cytological cervical abnormalities, or incidence of invasive cervcal cancer. Studies were eligible if they reported the association of combination ART or highly active ART use with the following outcomes: high-risk HPV prevalence; squamous intraepithelial lesion (SIL) or cervical intraepithelial neoplasia (CIN) prevalence, incidence, progression, or regression; and invasive cervical cancer incidence among women living with HIV. We did random-effects meta-analyses to estimate summary statistics. We examined heterogeneity with the I2 statistic. This review is registered on the PROSPERO database at the Centre of Reviews and Dissemination, University of York, York, UK (registration number CRD42016039546).FindingsWe identified 31 studies of the association of ART with prevalence of high-risk HPV (6537 women living with HIV) and high grade cervical lesions (HSIL-CIN2+; 9288 women living with HIV). Women living with HIV on ART had lower prevalence of high-risk HPV than did those not on ART (adjusted odds ratio [aOR] 0·83, 95% CI 0·70–0·99; I2=51%, adjusted for CD4 cell count and ART duration), and there was some evidence of association with HSIL-CIN2+ (0·65, 0·40–1·06; I2=30%). 17 studies reported the association of ART with longitudinal cervical lesion outcomes. ART was associated with a decreased risk of HSIL-CIN2+ incidence among 1830 women living with HIV (0·59, 0·40–0·87; I2=0%), SIL progression among 6212 women living with HIV (adjusted hazard ratio [aHR] 0·64, 95% CI 0·54–0·75; I2=18%), and increased likelihood of SIL or CIN regression among 5261 women living with HIV (1·54, 1·30–1·82; I2=0%). In three studies among 15 846 women living with HIV, ART was associated with a reduction in invasive cervical cancer incidence (crude HR 0·40, 95% CI 0·18–0·87, I2=33%).InterpretationEarly ART initiation and sustained adherence is likely to reduce incidence and progression of SIL and CIN and ultimately incidence of invasive cervical cancer. Future cohort studies should aim to confirm this possible effect.FundingUK Medical Research Council.

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“…Although HPV infection is the major cause of cervical cancer, several studies in the past have implicated cigarette smoking as a cofactor for cervical cancer in both HIV-infected and uninfected women 51 , 52 . Moreover, most of the recent studies have emphasized HPV infection, immunosuppression by HIV, age, abortion, and vaginal abnormalities as major risk factors for cervical cancer in HIV-infected women 50 , 53 – 55 . Only a few recent reports associate smoking with cervical cancer risk in HIV-infected women.…”

Section: Cervical Cancermentioning

confidence: 99%

Recent advances in cancer outcomes in HIV-positive smokers

Ranjit

Kumar

2018

F1000Res

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HIV-infected smokers are at relatively higher risk of cancer than HIV-infected non-smokers. HIV weakens the immune system and renders infected individuals more vulnerable to the carcinogenic effects of smoking. HIV-infected smokers suffer more aggressive forms of cancers than do non-smokers because of the cumulative effects of the virus and cigarette smoke carcinogens. The major types of cancer observed in HIV-infected smokers are lung, head and neck, esophageal, anal, and cervical cancers. In this review, we will discuss the recent advances in cancer outcomes, primarily in terms of cancer incidence, prevalence, and progression in HIV patients who are smokers.

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Prevalence and risk factors of cervical squamous intraepithelial lesions among HIV-infected women in Dar es Salaam, Tanzania

Cited by 14 publications

References 27 publications

Sociodemographic determinants of abnormal cervical cytology among HIV positive women in Nnewi, Nigeria

Sociodemographic determinants of abnormal cervical cytology among HIV positive women in Nnewi, Nigeria

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

Recent advances in cancer outcomes in HIV-positive smokers

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