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High-risk human papilloma virus and cervical abnormalities in HIV-infected women with normal cervical cytology.

Musa J, Achenbach C, Taiwo B, Berzins B, Silas O, Daru PH, Agbaji O, Imade G, Sagay AS, Idoko JA, Kanki PJ, Murphy RL - Infect. Agents Cancer (2014)

Bottom Line: We compared proportions of ACF as well as histologic grades of cervical intra-epithelial neoplasia (CIN) in women with or without HR-HPV.The odds for an ACF was statistically higher [OR = 4.0 (95% CI: 1.1-14.7)] in women with HR-HPV compared to those without.Overall, the proportion of women detected with any grade of CIN was 11.5% (9/78) and 6.4% (5/78) were CIN 2 or greater lesion (CIN2+).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University of Jos, Jos, Plateau State Nigeria ; AIDS Prevention Initiative in Nigeria, HIV program, Jos University Teaching Hospital, Jos, Plateau State Nigeria.

ABSTRACT

Background: The prevalence of High-Risk Human papilloma virus (HR-HPV), a necessary cause of invasive cervical cancer (ICC) is relatively high in HIV infected women. Gaps exist in our knowledge of the optimal approaches for managing women who have HR-HPV with normal cervical cytology (NCC) particularly in settings of HIV infection.

Methods: Between May 2012 and June 2013 we conducted a colposcopic assessment of HIV-infected women with prior (NCC) and known HR-HPV status to compare cervical abnormalities in women with and without HR-HPV. Colposcopic examinations were done at the Operation Stop Cervical Cancer (OSCC) unit of the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Abnormal colposcopic finding (ACF) was defined as areas of aceto-white epithelium involving the squamo-coulumnar junction, areas of punctation, mosaic pattern or atypical vessels. We compared proportions of ACF as well as histologic grades of cervical intra-epithelial neoplasia (CIN) in women with or without HR-HPV. Statistical analysis was done on STATA.

Results: We conducted colposcopic examinations in 78 out of 89 (86.5%) eligible women. The mean age of the cohort was 32.4 years (SD ±4.6) with a median 32 years (IQR 29-36). After a mean follow up time of 20.1 months from the initial cervical pap cytology and HR-HPV testing, we found 12 of 78 (15.4%) women with ACF. The odds for an ACF was statistically higher [OR = 4.0 (95% CI: 1.1-14.7)] in women with HR-HPV compared to those without. Of the twelve women with ACF, subsequent histologic examination of colposcopically directed cervical biopsies confirmed CIN 1 in 4 cases (33.3%), CIN 2 in 1 case (8.3%), CIN 3 in 2 cases (16.7%), carcinoma-in-situ (CIS) in 2 cases (16.7%), and normal cervix in 3 (25.0%). Overall, the proportion of women detected with any grade of CIN was 11.5% (9/78) and 6.4% (5/78) were CIN 2 or greater lesion (CIN2+).

Conclusion: HIV-infected women with NCC and HR-HPV had a four-fold higher likelihood for an ACF. The practice of early colposcopic examination of HIV-infected women with prior NCC and HR-HPV may increase early detection of higher grade CIN and CIS cancer stages in our setting.

No MeSH data available.


Related in: MedlinePlus

Normal colposcopic (1) and abnormal colposcopic (2) examinations in HIV infected women with positive HR-HPV compare to those negative for HR-HPV.
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Fig1: Normal colposcopic (1) and abnormal colposcopic (2) examinations in HIV infected women with positive HR-HPV compare to those negative for HR-HPV.

Mentions: Colposcopic examinations were performed after a mean of 20.1 months from the initial cervical pap cytology and HR-HPV status evaluation. The mean follow up time between initial Pap cytology and subsequent colposcopic evaluation was comparable for women who were positive HR-HPV (20.5 months) and those negative HR-HPV (19.9 months); p-value 0.554. Colposcopy revealed 12 of 78 (15.4%) women with abnormal findings. The odds ratio (OR) of having an abnormal colposcopic examination finding was 4.0 (95% CI: 1.1-14.7) in women who were HR-HPV positive compared to HR-HPV negative; p-value 0.039 (Table 1 and Figure 1).Figure 1


High-risk human papilloma virus and cervical abnormalities in HIV-infected women with normal cervical cytology.

Musa J, Achenbach C, Taiwo B, Berzins B, Silas O, Daru PH, Agbaji O, Imade G, Sagay AS, Idoko JA, Kanki PJ, Murphy RL - Infect. Agents Cancer (2014)

Normal colposcopic (1) and abnormal colposcopic (2) examinations in HIV infected women with positive HR-HPV compare to those negative for HR-HPV.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230523&req=5

Fig1: Normal colposcopic (1) and abnormal colposcopic (2) examinations in HIV infected women with positive HR-HPV compare to those negative for HR-HPV.
Mentions: Colposcopic examinations were performed after a mean of 20.1 months from the initial cervical pap cytology and HR-HPV status evaluation. The mean follow up time between initial Pap cytology and subsequent colposcopic evaluation was comparable for women who were positive HR-HPV (20.5 months) and those negative HR-HPV (19.9 months); p-value 0.554. Colposcopy revealed 12 of 78 (15.4%) women with abnormal findings. The odds ratio (OR) of having an abnormal colposcopic examination finding was 4.0 (95% CI: 1.1-14.7) in women who were HR-HPV positive compared to HR-HPV negative; p-value 0.039 (Table 1 and Figure 1).Figure 1

Bottom Line: We compared proportions of ACF as well as histologic grades of cervical intra-epithelial neoplasia (CIN) in women with or without HR-HPV.The odds for an ACF was statistically higher [OR = 4.0 (95% CI: 1.1-14.7)] in women with HR-HPV compared to those without.Overall, the proportion of women detected with any grade of CIN was 11.5% (9/78) and 6.4% (5/78) were CIN 2 or greater lesion (CIN2+).

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University of Jos, Jos, Plateau State Nigeria ; AIDS Prevention Initiative in Nigeria, HIV program, Jos University Teaching Hospital, Jos, Plateau State Nigeria.

ABSTRACT

Background: The prevalence of High-Risk Human papilloma virus (HR-HPV), a necessary cause of invasive cervical cancer (ICC) is relatively high in HIV infected women. Gaps exist in our knowledge of the optimal approaches for managing women who have HR-HPV with normal cervical cytology (NCC) particularly in settings of HIV infection.

Methods: Between May 2012 and June 2013 we conducted a colposcopic assessment of HIV-infected women with prior (NCC) and known HR-HPV status to compare cervical abnormalities in women with and without HR-HPV. Colposcopic examinations were done at the Operation Stop Cervical Cancer (OSCC) unit of the Jos University Teaching Hospital (JUTH), Jos, Nigeria. Abnormal colposcopic finding (ACF) was defined as areas of aceto-white epithelium involving the squamo-coulumnar junction, areas of punctation, mosaic pattern or atypical vessels. We compared proportions of ACF as well as histologic grades of cervical intra-epithelial neoplasia (CIN) in women with or without HR-HPV. Statistical analysis was done on STATA.

Results: We conducted colposcopic examinations in 78 out of 89 (86.5%) eligible women. The mean age of the cohort was 32.4 years (SD ±4.6) with a median 32 years (IQR 29-36). After a mean follow up time of 20.1 months from the initial cervical pap cytology and HR-HPV testing, we found 12 of 78 (15.4%) women with ACF. The odds for an ACF was statistically higher [OR = 4.0 (95% CI: 1.1-14.7)] in women with HR-HPV compared to those without. Of the twelve women with ACF, subsequent histologic examination of colposcopically directed cervical biopsies confirmed CIN 1 in 4 cases (33.3%), CIN 2 in 1 case (8.3%), CIN 3 in 2 cases (16.7%), carcinoma-in-situ (CIS) in 2 cases (16.7%), and normal cervix in 3 (25.0%). Overall, the proportion of women detected with any grade of CIN was 11.5% (9/78) and 6.4% (5/78) were CIN 2 or greater lesion (CIN2+).

Conclusion: HIV-infected women with NCC and HR-HPV had a four-fold higher likelihood for an ACF. The practice of early colposcopic examination of HIV-infected women with prior NCC and HR-HPV may increase early detection of higher grade CIN and CIS cancer stages in our setting.

No MeSH data available.


Related in: MedlinePlus