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Cervical cytological changes in HIV-infected patients attending care and treatment clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.

Mwakigonja AR, Torres LM, Mwakyoma HA, Kaaya EE - Infect. Agents Cancer (2012)

Bottom Line: The frequency of SIL and carcinoma appeared to be higher among HIV-infected women on HAART compared to seronegative controls and as expected increased with age.HIV seropositive patients appeared to present earlier with SIL compared to those HIV seronegative suggesting a role of HIV in altering the natural history of HPV infection and cervical lesions.The absence of p53 immunoreactivity in HPV + lesions is indicative of the ability of HPV E6 proteins to interact with the tumor suppressor gene and pave way for viral-induced oncogenesis in the studied Tanzanian women.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Muhimbili University of Health and Allied Sciences (MUHAS), P,O, Box 65001, Dar es Salaam, Tanzania. rodgeramos@yahoo.com.

ABSTRACT

Background: Tanzania is among Sub-Saharan countries mostly affected by the HIV and AIDS pandemic, females being more vulnerable than males. HIV infected women appear to have a higher rate of persistent infection by high risk types of human papillomavirus (HPV) strongly associated with high-grade squamous intraepithelial lesions (HSIL) and invasive cervical carcinoma. Furthermore, although HIV infection and cervical cancer are major public health problems, the frequency and HIV/HPV association of cervical cancer and HSIL is not well documented in Tanzania, thus limiting the development of preventive and therapeutic strategies.

Methods: A prospective unmatched, case-control study of HIV-seropositive, ≥ 18 years of age and consenting non-pregnant patients attending the care and treatment center (CTC) at Muhimbili National Hoospital (MNH) as cases was done between 2005 and 2006. HIV seronegative, non-pregnant and consenting women recruited from the Cervical Cancer Screening unit (CCSU) at ORCI were used as controls while those who did not consent to study participation and/or individuals under < 18 years were excluded. Pap smears were collected for routine cytodiagnosis and P53 immunohistochemistry (IHC). Cervical lesions were classified according to the Modified Bethesda System.

Results: A total of 170 participants from the two centers were recruited including 50 HIV-seronegative controls were from the CCSU. Ages ranged from 20-66 years (mean 40.5 years) for cases and 20-69 years (mean 41.6 years) for controls. The age group 36-45 years was the most affected by HIV (39.2%, n = 47). Cervicitis, squamous intraepithelial lesions (SIL) and carcinoma constituted 28.3% (n = 34), 38.3% (n = 46) and 5.8% (n = 7) respectively among cases, and 28% (n = 14), 34% (n = 17) and 2% (n = 1) for controls, although this was not statistically significant (P-value = 0.61). IHC showed that p53 was not detectable in HPV + Pap smears and cell blocks indicating possible degradation.

Conclusions: The frequency of SIL and carcinoma appeared to be higher among HIV-infected women on HAART compared to seronegative controls and as expected increased with age. HIV seropositive patients appeared to present earlier with SIL compared to those HIV seronegative suggesting a role of HIV in altering the natural history of HPV infection and cervical lesions. The absence of p53 immunoreactivity in HPV + lesions is indicative of the ability of HPV E6 proteins to interact with the tumor suppressor gene and pave way for viral-induced oncogenesis in the studied Tanzanian women.

No MeSH data available.


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The distribution of patients according to marital status and HIV infection. Histograms showing the distribution of patients according to marital status and HIV infection.
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Figure 1: The distribution of patients according to marital status and HIV infection. Histograms showing the distribution of patients according to marital status and HIV infection.

Mentions: A total of 170 women were recruited from the two centers (120 HIV-seropositive cases on HAART from MNH and 50 seronegative controls from ORCI) between 2005 and 2006. Singles constituted 64.1% (77/120) of cases and only 26% (13/50) of controls. The rest of women in each group were married which difference was highly statistically significant (P-value < 0.001), suggesting that singles were more likely to be HIV-infected (Figure 1 and Table 1). Age ranged from 20-66 years (mean 40.5 years) among cases and from 20-69 years (mean 41.6 years) for Controls. The age group of 36-45 years was the most affected (39.2%, 47/120) by HIV infection (Table 1).


Cervical cytological changes in HIV-infected patients attending care and treatment clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.

Mwakigonja AR, Torres LM, Mwakyoma HA, Kaaya EE - Infect. Agents Cancer (2012)

The distribution of patients according to marital status and HIV infection. Histograms showing the distribution of patients according to marital status and HIV infection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3298791&req=5

Figure 1: The distribution of patients according to marital status and HIV infection. Histograms showing the distribution of patients according to marital status and HIV infection.
Mentions: A total of 170 women were recruited from the two centers (120 HIV-seropositive cases on HAART from MNH and 50 seronegative controls from ORCI) between 2005 and 2006. Singles constituted 64.1% (77/120) of cases and only 26% (13/50) of controls. The rest of women in each group were married which difference was highly statistically significant (P-value < 0.001), suggesting that singles were more likely to be HIV-infected (Figure 1 and Table 1). Age ranged from 20-66 years (mean 40.5 years) among cases and from 20-69 years (mean 41.6 years) for Controls. The age group of 36-45 years was the most affected (39.2%, 47/120) by HIV infection (Table 1).

Bottom Line: The frequency of SIL and carcinoma appeared to be higher among HIV-infected women on HAART compared to seronegative controls and as expected increased with age.HIV seropositive patients appeared to present earlier with SIL compared to those HIV seronegative suggesting a role of HIV in altering the natural history of HPV infection and cervical lesions.The absence of p53 immunoreactivity in HPV + lesions is indicative of the ability of HPV E6 proteins to interact with the tumor suppressor gene and pave way for viral-induced oncogenesis in the studied Tanzanian women.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, Muhimbili University of Health and Allied Sciences (MUHAS), P,O, Box 65001, Dar es Salaam, Tanzania. rodgeramos@yahoo.com.

ABSTRACT

Background: Tanzania is among Sub-Saharan countries mostly affected by the HIV and AIDS pandemic, females being more vulnerable than males. HIV infected women appear to have a higher rate of persistent infection by high risk types of human papillomavirus (HPV) strongly associated with high-grade squamous intraepithelial lesions (HSIL) and invasive cervical carcinoma. Furthermore, although HIV infection and cervical cancer are major public health problems, the frequency and HIV/HPV association of cervical cancer and HSIL is not well documented in Tanzania, thus limiting the development of preventive and therapeutic strategies.

Methods: A prospective unmatched, case-control study of HIV-seropositive, ≥ 18 years of age and consenting non-pregnant patients attending the care and treatment center (CTC) at Muhimbili National Hoospital (MNH) as cases was done between 2005 and 2006. HIV seronegative, non-pregnant and consenting women recruited from the Cervical Cancer Screening unit (CCSU) at ORCI were used as controls while those who did not consent to study participation and/or individuals under < 18 years were excluded. Pap smears were collected for routine cytodiagnosis and P53 immunohistochemistry (IHC). Cervical lesions were classified according to the Modified Bethesda System.

Results: A total of 170 participants from the two centers were recruited including 50 HIV-seronegative controls were from the CCSU. Ages ranged from 20-66 years (mean 40.5 years) for cases and 20-69 years (mean 41.6 years) for controls. The age group 36-45 years was the most affected by HIV (39.2%, n = 47). Cervicitis, squamous intraepithelial lesions (SIL) and carcinoma constituted 28.3% (n = 34), 38.3% (n = 46) and 5.8% (n = 7) respectively among cases, and 28% (n = 14), 34% (n = 17) and 2% (n = 1) for controls, although this was not statistically significant (P-value = 0.61). IHC showed that p53 was not detectable in HPV + Pap smears and cell blocks indicating possible degradation.

Conclusions: The frequency of SIL and carcinoma appeared to be higher among HIV-infected women on HAART compared to seronegative controls and as expected increased with age. HIV seropositive patients appeared to present earlier with SIL compared to those HIV seronegative suggesting a role of HIV in altering the natural history of HPV infection and cervical lesions. The absence of p53 immunoreactivity in HPV + lesions is indicative of the ability of HPV E6 proteins to interact with the tumor suppressor gene and pave way for viral-induced oncogenesis in the studied Tanzanian women.

No MeSH data available.


Related in: MedlinePlus