Prevalence of risk factors associated with human papillomavirus infection in women living with HIV
Identifieur interne : 000112 ( Pmc/Curation ); précédent : 000111; suivant : 000113Prevalence of risk factors associated with human papillomavirus infection in women living with HIV
Auteurs : C. Hankins ; F. Coutlée ; N. Lapointe ; P. Simard ; T. Tran ; J. Samson ; L. HumSource :
- CMAJ: Canadian Medical Association Journal [ 0820-3946 ] ; 1999.
Abstract
BACKGROUND: Concurrent infection with HIV and human papillomavirus (HPV) in women is associated with increased rates of cervical dysplasia and shorter survival following the development of cervical cancer. The authors examined risk factors for HPV infection at study entry in HIV-positive women enrolled in the Canadian Women's HIV Study, a prospective open cohort study. METHODS: Subjects eligible for this analysis included the 375 HIV-positive women in the Canadian Women's HIV Study for whom HPV test results were available. Questionnaires on behavioural and clinical information, Pap smears, cervicovaginal lavage specimens and vaginal tampon specimens for HPV detection and typing by polymerase chain reaction were obtained at study entry. RESULTS: Overall, 67.2% (252/375) of the women were HPV-positive; the global prevalence of intermediate- and high-risk oncogenic HPV types was 49.1% (184/375). Women with squamous cell dysplasia (32/294) were more likely to have HPV infection than those without dysplasia (90.6% v. 62.6%; p = 0.002). Multivariate logistic regression analysis, with adjustment for number of lifetime partners and history of STD, revealed that the following risk factors were independently associated with HPV infection: CD4 count of less than 0.20 x 10(9)/L (adjusted odds ratio [OR] 1.99 [95% confidence interval (Cl) 1.17-3.37 (p = 0.011)]), non-white race (adjusted OR 2.00 [95% Cl 1.17-3.42 (p = 0.011)]), inconsistent condom use in the 6 months before study entry (adjusted OR 2.02 [95% Cl 1.16-3.50 (p = 0.013)]), and lower age, with women age 30-39 years (adjusted OR 0.51 [95% Cl 0.30-0.87 (p = 0.013)]) and age 40 years or older (adjusted OR 0.52 [95% Cl 0.26-1.01 (p = 0.052)]) compared with women less than 30 years of age. INTERPRETATION: Close monitoring for HPV-related effects is warranted in all HIV-positive women, particularly younger, non-white women who do not always use condoms. Counselling for women living with HIV, particularly younger women, should emphasize the importance of regular cytological screening, with increasing frequency as the CD4 count falls.
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PubMed: 9951439
PubMed Central: 1229988
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Prevalence of risk factors associated with human papillomavirus infection in women living with HIV</title><author><name sortKey="Hankins, C" sort="Hankins, C" uniqKey="Hankins C" first="C" last="Hankins">C. Hankins</name></author><author><name sortKey="Coutlee, F" sort="Coutlee, F" uniqKey="Coutlee F" first="F" last="Coutlée">F. Coutlée</name></author><author><name sortKey="Lapointe, N" sort="Lapointe, N" uniqKey="Lapointe N" first="N" last="Lapointe">N. Lapointe</name></author><author><name sortKey="Simard, P" sort="Simard, P" uniqKey="Simard P" first="P" last="Simard">P. Simard</name></author><author><name sortKey="Tran, T" sort="Tran, T" uniqKey="Tran T" first="T" last="Tran">T. Tran</name></author><author><name sortKey="Samson, J" sort="Samson, J" uniqKey="Samson J" first="J" last="Samson">J. Samson</name></author><author><name sortKey="Hum, L" sort="Hum, L" uniqKey="Hum L" first="L" last="Hum">L. Hum</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">9951439</idno><idno type="pmc">1229988</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1229988</idno><idno type="RBID">PMC:1229988</idno><date when="1999">1999</date><idno type="wicri:Area/Pmc/Corpus">000113</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000113</idno><idno type="wicri:Area/Pmc/Curation">000112</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000112</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Prevalence of risk factors associated with human papillomavirus infection in women living with HIV</title><author><name sortKey="Hankins, C" sort="Hankins, C" uniqKey="Hankins C" first="C" last="Hankins">C. Hankins</name></author><author><name sortKey="Coutlee, F" sort="Coutlee, F" uniqKey="Coutlee F" first="F" last="Coutlée">F. Coutlée</name></author><author><name sortKey="Lapointe, N" sort="Lapointe, N" uniqKey="Lapointe N" first="N" last="Lapointe">N. Lapointe</name></author><author><name sortKey="Simard, P" sort="Simard, P" uniqKey="Simard P" first="P" last="Simard">P. Simard</name></author><author><name sortKey="Tran, T" sort="Tran, T" uniqKey="Tran T" first="T" last="Tran">T. Tran</name></author><author><name sortKey="Samson, J" sort="Samson, J" uniqKey="Samson J" first="J" last="Samson">J. Samson</name></author><author><name sortKey="Hum, L" sort="Hum, L" uniqKey="Hum L" first="L" last="Hum">L. Hum</name></author></analytic><series><title level="j">CMAJ: Canadian Medical Association Journal</title><idno type="ISSN">0820-3946</idno><idno type="eISSN">1488-2329</idno><imprint><date when="1999">1999</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>BACKGROUND: Concurrent infection with HIV and human papillomavirus (HPV) in women is associated with increased rates of cervical dysplasia and shorter survival following the development of cervical cancer. The authors examined risk factors for HPV infection at study entry in HIV-positive women enrolled in the Canadian Women's HIV Study, a prospective open cohort study. METHODS: Subjects eligible for this analysis included the 375 HIV-positive women in the Canadian Women's HIV Study for whom HPV test results were available. Questionnaires on behavioural and clinical information, Pap smears, cervicovaginal lavage specimens and vaginal tampon specimens for HPV detection and typing by polymerase chain reaction were obtained at study entry. RESULTS: Overall, 67.2% (252/375) of the women were HPV-positive; the global prevalence of intermediate- and high-risk oncogenic HPV types was 49.1% (184/375). Women with squamous cell dysplasia (32/294) were more likely to have HPV infection than those without dysplasia (90.6% v. 62.6%; p = 0.002). Multivariate logistic regression analysis, with adjustment for number of lifetime partners and history of STD, revealed that the following risk factors were independently associated with HPV infection: CD4 count of less than 0.20 x 10(9)/L (adjusted odds ratio [OR] 1.99 [95% confidence interval (Cl) 1.17-3.37 (p = 0.011)]), non-white race (adjusted OR 2.00 [95% Cl 1.17-3.42 (p = 0.011)]), inconsistent condom use in the 6 months before study entry (adjusted OR 2.02 [95% Cl 1.16-3.50 (p = 0.013)]), and lower age, with women age 30-39 years (adjusted OR 0.51 [95% Cl 0.30-0.87 (p = 0.013)]) and age 40 years or older (adjusted OR 0.52 [95% Cl 0.26-1.01 (p = 0.052)]) compared with women less than 30 years of age. INTERPRETATION: Close monitoring for HPV-related effects is warranted in all HIV-positive women, particularly younger, non-white women who do not always use condoms. Counselling for women living with HIV, particularly younger women, should emphasize the importance of regular cytological screening, with increasing frequency as the CD4 count falls.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">CMAJ</journal-id><journal-title>CMAJ: Canadian Medical Association Journal</journal-title><issn pub-type="ppub">0820-3946</issn><issn pub-type="epub">1488-2329</issn></journal-meta><article-meta><article-id pub-id-type="pmid">9951439</article-id><article-id pub-id-type="pmc">1229988</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Prevalence of risk factors associated with human papillomavirus infection in women living with HIV</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Hankins</surname><given-names>C</given-names></name></contrib><contrib contrib-type="author"><name><surname>Coutlée</surname><given-names>F</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lapointe</surname><given-names>N</given-names></name></contrib><contrib contrib-type="author"><name><surname>Simard</surname><given-names>P</given-names></name></contrib><contrib contrib-type="author"><name><surname>Tran</surname><given-names>T</given-names></name></contrib><contrib contrib-type="author"><name><surname>Samson</surname><given-names>J</given-names></name></contrib><contrib contrib-type="author"><name><surname>Hum</surname><given-names>L</given-names></name></contrib><aff>Infectious Diseases Unit, Montreal Regional Public Health Department, Que.<email>md77@musica.mcgill.ca</email></aff></contrib-group><pub-date pub-type="ppub"><day>26</day><month>1</month><year>1999</year></pub-date><volume>160</volume><issue>2</issue><fpage>185</fpage><lpage>191</lpage><copyright-statement>© 1999 Canadian Medical Association</copyright-statement><copyright-year>1999</copyright-year><abstract><p>BACKGROUND: Concurrent infection with HIV and human papillomavirus (HPV) in women is associated with increased rates of cervical dysplasia and shorter survival following the development of cervical cancer. The authors examined risk factors for HPV infection at study entry in HIV-positive women enrolled in the Canadian Women's HIV Study, a prospective open cohort study. METHODS: Subjects eligible for this analysis included the 375 HIV-positive women in the Canadian Women's HIV Study for whom HPV test results were available. Questionnaires on behavioural and clinical information, Pap smears, cervicovaginal lavage specimens and vaginal tampon specimens for HPV detection and typing by polymerase chain reaction were obtained at study entry. RESULTS: Overall, 67.2% (252/375) of the women were HPV-positive; the global prevalence of intermediate- and high-risk oncogenic HPV types was 49.1% (184/375). Women with squamous cell dysplasia (32/294) were more likely to have HPV infection than those without dysplasia (90.6% v. 62.6%; p = 0.002). Multivariate logistic regression analysis, with adjustment for number of lifetime partners and history of STD, revealed that the following risk factors were independently associated with HPV infection: CD4 count of less than 0.20 x 10(9)/L (adjusted odds ratio [OR] 1.99 [95% confidence interval (Cl) 1.17-3.37 (p = 0.011)]), non-white race (adjusted OR 2.00 [95% Cl 1.17-3.42 (p = 0.011)]), inconsistent condom use in the 6 months before study entry (adjusted OR 2.02 [95% Cl 1.16-3.50 (p = 0.013)]), and lower age, with women age 30-39 years (adjusted OR 0.51 [95% Cl 0.30-0.87 (p = 0.013)]) and age 40 years or older (adjusted OR 0.52 [95% Cl 0.26-1.01 (p = 0.052)]) compared with women less than 30 years of age. INTERPRETATION: Close monitoring for HPV-related effects is warranted in all HIV-positive women, particularly younger, non-white women who do not always use condoms. Counselling for women living with HIV, particularly younger women, should emphasize the importance of regular cytological screening, with increasing frequency as the CD4 count falls.</p></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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