Short-term follow up of cervical squamous intraepithelial lesions associated with HIV and human papillomavirus infections in Africa

Ruche, Guy La; Leroy, Valériane; Mensah-Ado, Isabelle; Ramón, Rosa; You, Bruno; Bergeron, Christine; Mothebesoane-Anoh, S; Toure-Coulibaly, K.; Dabis, François

doi:10.1258/0956462991914276

Cited by 19 publications

(10 citation statements)

References 24 publications

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“…Two studies followed women with ASCUS at baseline 33,34 , finding a rate of 13.7 cases of SIL per 100 women-years and 3.2 cases of HSIL per 100 women-years. Study cumulative risks, though not comparable between studies, were higher for HIV-positive participants than for HIV-negative participants in all five studies that included both populations 10,33,35,37,39 .…”

Section: Resultsmentioning

confidence: 76%

“…Four of the studies were conducted in the USA 33–36 , 4 in the European Union with one including women from France and French Guiana 7,10,37,38 , 2 in Africa 28,39 , and 1 in Brazil. No studies came from Asia, Australia, Central America, or Eastern Europe.…”

Section: Resultsmentioning

confidence: 99%

“…Eight of the studies reported a proportion of the participants receiving ART (2 ART, 1 HAART, and 5 mixed ART/HAART) 7,10,28,33–36,38 . In 3 studies ART use was not specified 37,39,40 . In none of the study populations were all participants receiving ART.…”

Section: Resultsmentioning

confidence: 99%

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Incidence and progression of cervical lesions in women with HIV: a systematic global review

et al. 2013

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Summary Objective Global data on cervical lesion incidence and progression in HIV-positive is essential for understanding the natural history of cervical neoplasia and informing screening policy. Methods A systematic review was performed summarizing the incidence and progression of cervical lesions in HIV-positive women. Results Of 5,882 HIV-positive women from 15 studies, incidence ranged from 4.9 to 21.1 cases per 100 woman-years for any cervical lesion and 0.4 to 8.8 cases per 100 woman-years for high grade cervical lesions. HIV-positive women showed a median 3-fold higher incidence of cervical lesions compared to HIV-negative women. Of 1,099 HIV-positive women from 11 studies, progression from low to high grade lesions ranged from 1.2 to 26.2 cases per 100 woman-years. Both incidence and progression rates increased with lower CD4 counts. The effect of antiretroviral therapy on the natural history of cervical neoplasia remains unclear. Conclusions HIV-positive women have higher incidence and progression of cervical neoplasia. Cervical cancer screening should be integrated into HIV treatment programs.

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Section: Resultsmentioning

confidence: 76%

Section: Resultsmentioning

confidence: 99%

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Incidence and progression of cervical lesions in women with HIV: a systematic global review

et al. 2013

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“…Indeed, HIV-positive women have been shown to have both higher rates of CIN prevalence and of low-grade lesion persistence 43,44 . One recent report has even provided a biological mechanism for increased cervical carcinogenesis via HIV infection through the mediation of COX-2 expression, a molecule linked to cervical carcinogenesis 45 .…”

Section: Discussionmentioning

confidence: 99%

Influence of HIV-1 and/or HIV-2 infection and CD4 count on cervical HPV DNA detection in women from Senegal, West Africa

Hanisch¹,

Sow²,

Toure³

et al. 2013

Journal of Clinical Virology

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Background HIV infection is associated with greater risk of precancerous lesions and cervical cancer in women. However, several factors remain unclarified regarding the association between HIV infection and HPV detection, especially among those with HIV type 2 versus type 1 infection and severely immunocompromised persons. Objectives To evaluate HPV overall and type-specific detection among HIV-infected and uninfected women in Senegal. Study Design Detection of HPV DNA for 38 genotypes in cervical swabs using PCR-based methods was evaluated in HIV-positive (n=467) and HIV-negative (n=2139) women participating in studies in Senegal. Among HIV-1 and/or HIV-2 positive women, CD4 counts were assessed. Adjusted multivariable prevalence ratios (PR) were calculated. Results The prevalence of any HPV DNA and multiple HPV types was greater among HIV-infected individuals (78.2% and 62.3%, respectively) compared with HIV-negative women (27.1% and 11.6%). This trend was also seen for HPV types 16 and 18 (13.1% and 10.9%) compared to HIV-negative women (2.2% and 1.7%). HIV-infected women with CD4 cell counts less than 200 cells/µl had a higher likelihood of any HPV detection (PRa 1.30; 95% CI 1.07–1.59), multiple HPV types (PRa 1.52; 95% CI 1.14–2.01), and HPV-16 (PRa 9.00; 95% CI 1.66–48.67), but not HPV-18 (PRa 1.20, 95% CI 0.45–3.24) compared to those with CD4 counts 500 cells/µl or above. Conclusion HIV-infected women, especially those most severely immunocompromised, are more likely to harbor HPV. Measures to prevent initial HPV infection and subsequent development of cervical cancer through focused screening efforts should be implemented in these high risk populations.

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“…In sub-Saharan Africa, for instance, where two thirds of the world's HIV-infected population live, HPV types vary by country and HIV status and differ significantly from HPV types seen in other regions of the world, possibly in part due to geographic and genetic variation in HLA haplotypes [11–15]. Multiple prospective studies have demonstrated that women with HIV infection are much more likely than HIV-negative women to have persistent HPV, often with oncogenic subtypes [16–18]. It has been estimated that a vaccine against HPV types 16 and 18 would theoretically prevent 71% of cervical cancers worldwide, but would preferentially favor Asia and North America over Africa and South America [14].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of HPV in HIV-Positive and HIV-Negative Fertile Women in Cameroon, West Africa

Desruisseau

Schmidt-Grimminger

Welty

2009

Infectious Diseases in Obstetrics and Gynecology

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Background. HPV types vary by country and HIV status. There are no data on the prevalent HPV genotypes from Cameroon. Methods. We conducted a cross-sectional, observational study on 65 Cameroonian women. Samples were sent for HPV genotyping and Thin Prep analyses. Results. 41 out of 61 samples tested (67.2%) had HPV subtypes detected. The most common high risk types encountered were: 45 (24.6%) and 58 (21.5%). HIV-positive women were more likely to test positive for any HPV (P = .014), have more than one HPV subtype (P = .003), and to test positive for the high risk subtypes (P = .007). Of those with high risk HPV, HIV-positive women were more likely to have Thin Prep abnormalities than HIV-negative women (P = .013). Conclusions. Oncogenic HPV subtypes 45 and 58 were more prevalent than those subtypes carried in the quadrivalent vaccine. Further studies are needed to assess whether the current vaccine will be effective in this region.

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Short-term follow up of cervical squamous intraepithelial lesions associated with HIV and human papillomavirus infections in Africa

Cited by 19 publications

References 24 publications

Incidence and progression of cervical lesions in women with HIV: a systematic global review

Incidence and progression of cervical lesions in women with HIV: a systematic global review

Influence of HIV-1 and/or HIV-2 infection and CD4 count on cervical HPV DNA detection in women from Senegal, West Africa

Epidemiology of HPV in HIV-Positive and HIV-Negative Fertile Women in Cameroon, West Africa

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