Prevalence and risk factors for cervical intraepithelial neoplasia among HIV-infected women

• Published in: The Brazilian journal of infectious diseases
• Main Authors: Pereira Teixeira, Nara Chartuni, Labanca Araújo, Angela Cristina, Miranda Correa, Christine, Teixeira da Costa Lodi, Claudia, Miranda Lima, Maria Inês, de Oliveira Carvalho, Nara, Mendez del Castillo, Dora, Hugo Melo, Victor
• Format: Journal Article
• Language: English
• Published: Elsevier Editora Ltda
• Subjects: Cervical intraepithelial neoplasia; DNA probes; HIV; HPV; Immunosuppression; Immunosuppression; HIV; DNA probes; Cervical intraepithelial neoplasia; HPV
• ISSN: 1413-8670
• DOI: 10.1016/j.bjid.2011.12.002

To evaluate the prevalence and the risk factors for cervical intraepithelial neoplasia (CIN) among HIV-infected women. Cross-sectional study of 494 HIV-infected women in Brazil, between 1998 and 2008. Gynecologic exam was performed, and samples were collected for cervical cytology and for HPV DNA detection. Cervical biopsy was carried out when indicated. HPV infection, CD4 T-lymphocyte count and HIV viral load were compared with cervical histopathology. Univariate and multivariate statistical analyses were performed to evaluate the statistical association of several risk factors. CIN prevalence detected by histopathology was 23.4% (6% of CIN2/3 and 17.4% cases of CIN1). Multivariate analysis confirmed an independent association of CIN with CD4 T-lymphocyte count below 200 cells/mm3 (OR 5.0, 95% CI 2.5- 10.1), with a positive detection of HPV DNA (OR 2.0, 95% CI 1.2-3.5), and with age ≤ 34 years old (OR 1.5, 95% CI 1.0-2.4). HIV viral load and antiretroviral use were not independent risk factors for CIN. Severity of immunosupression, presence of HPV infection and younger age are strong predictors of CIN among HIV-infected women.