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Infectious Agents and Cancer

, 9:36

Clinical oncology

Abstract

BackgroundThe 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.

MethodsBetween 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.

ResultsWe 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+.

ConclusionHIV-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.

KeywordsHR-HPV HIV Cervical cytology Cervical cancer Nigeria Electronic supplementary materialThe online version of this article doi:10.1186-1750-9378-9-36 contains supplementary material, which is available to authorized users.

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Autor: Jonah Musa - Chad Achenbach - Babafemi Taiwo - Baiba Berzins - Olugbenga Silas - Patrick H Daru - Oche Agbaji - Godwin Im

Fuente: https://link.springer.com/



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