Increased Risk of High-Grade Cervical Squamous Intraepithelial Lesions and Invasive Cervical Cancer among African Women with Human Immunodeficiency Virus Type 1 and 2 Infections

• Published in: The Journal of infectious diseases Vol. 188; no. 4; pp. 555 - 563
• Main Authors: Hawes, Stephen E., Critchlow, Cathy W., Niang, Mame A. Faye, Diouf, Mame B., Diop, Aissatou, Touré, Papa, Kasse, Abdoul Aziz, Dembele, Birama, Sow, Papa Salif, Coll-Seck, Awa M., Kuypers, Jane M., Kiviat, Nancy B.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15-08-2003; University of Chicago Press; Oxford University Press
• Subjects: Adult; AIDS; AIDS-Related Opportunistic Infections - pathology; Biological and medical sciences; Carcinoma, Squamous Cell - complications; Carcinoma, Squamous Cell - pathology; CD4 Lymphocyte Count; Central African Republic - epidemiology; Cervical cancer; Cervix Uteri - pathology; Female; HIV; HIV 1; HIV 2; HIV infections; HIV Infections - blood; HIV Infections - complications; HIV-1 - physiology; HIV-2 - physiology; Hiv/Aids; Human viral diseases; Humans; Infections; Infectious diseases; Lesions; Medical sciences; Papillomaviridae; Papillomavirus Infections - complications; Papillomavirus Infections - pathology; Risk Factors; RNA; RNA, Viral - blood; Tumor Virus Infections - complications; Tumor Virus Infections - pathology; Uterine Cervical Neoplasms - complications; Uterine Cervical Neoplasms - pathology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Viruses; Africa; Central African Republic; Human; Immunopathology; High risk; Retroviridae; AIDS; Immune deficiency; Lentivirus; Female genital diseases; HIV-2 virus; Infection; Virus; Viral disease; Female; Human immunodeficiency virus; Lesion; Uterine cervix diseases; Cervical cancer
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/376996

To assess the risk of prevalent high-grade cervical squamous intraepithelial lesions (HSILs) or invasive cervical cancer (ICC) associated with human immunodeficiency virus (HIV) type 1, HIV-2, and human papillomavirus (HPV) infections, HIV load, and CD4 cell count, we studied 4119 women attending an outpatient clinic in Senegal. HIV infection was associated with increased rates of cervical infection with high-risk HPVs. Among women infected with high-risk HPVs, those with HIV-1 (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.0–4.8), HIV-2 (OR, 6.0; 95% CI, 2.1–17.1), or dual HIV infection (OR, 8.0; 95% CI, 2.0–31.5) were more likely to have HSILs or ICC diagnosed than were HIV-negative women; this association was not observed among women not infected with high-risk HPVs. Among women with HIV, higher HIV plasma RNA loads and lower CD4 cell counts were associated with high-risk HPV infection and degree of cervical abnormality. Furthermore, HIV-2–positive women were more likely to have HSILs (OR, 3.3; 95% CI, 0.9–12.4) or ICC (OR, 7.9; 95% CI, 1.1–57) than were HIV-1–positive women