HIV and Pre-Neoplastic and Neoplastic Lesions of the Cervix in South Africa: A Case-Control StudyReportar como inadecuado

HIV and Pre-Neoplastic and Neoplastic Lesions of the Cervix in South Africa: A Case-Control Study

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Moodley, Jennifer R, Margaret Hoffman, Henri Carrara, Bruce R Allan, Diane D Cooper, Lynn Rosenberg, Lynette E Denny, Samuel Shapiro, Anna-Lise Williamson. -HIV and pre-neoplastic and neoplastic lesions of the cervix in South Africa: a case-control study- BMC Cancer 6:135. 2006


BACKGROUND. Cervical cancer and infection with human immunodeficiency virus HIV are both major public health problems in South Africa. The aim of this study was to determine the risk of cervical pre-cancer and cancer among HIV positive women in South Africa. METHODS. Data were derived from a case-control study that examined the association between hormonal contraceptives and invasive cervical cancer. The study was conducted in the Western Cape South Africa, from January 1998 to December 2001. There were 486 women with invasive cervical cancer, 103 control women with atypical squamous cells of undetermined significance ASCUS, 53 with low-grade squamous intraepithelial lesions LSIL, 50 with high-grade squamous intraepithelial lesions HSIL and 1159 with normal cytology. Odds ratios OR and 95% confidence intervals CI were calculated using multiple logistic regression. RESULTS. The adjusted odds ratios associated with HIV infection were: 4.4 95% CI 2.3 – 8.4 for ASCUS, 7.4 3.5 – 15.7 for LSIL, 5.8 2.4 – 13.6 for HSIL and 1.17 0.75 – 1.85 for invasive cervical cancer. HIV positive women were nearly 5 times more likely to have high-risk human papillomavirus infection HR-HPV present compared to HIV negative women OR 4.6 95 % CI 2.8 – 7.5. Women infected with both HIV and high-risk HPV had a more than 40 fold higher risk of SIL than women infected with neither of these viruses. CONCLUSION. HIV positive women were at an increased risk of cervical pre-cancer, but did not demonstrate an excess risk of invasive cervical cancer. An interaction between HIV and HR-HPV infection was demonstrated. Our findings underscore the importance of developing locally relevant screening and management guidelines for HIV positive women in South Africa.Rights

Copyright 2006 Moodley et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Slone Epidemiology Center Papers -

Autor: Moodley, Jennifer R. - Hoffman, Margaret - Carrara, Henri - Allan, Bruce R. - Cooper, Diane D. - Rosenberg, Lynn - Denny, Lynette


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