Veteran Women Living With Human Immunodeficiency Virus Have Increased Risk of Human Papillomavirus (HPV)-Associated Genital Tract Cancers.

Autor:	Clark, Eva, Chen, Liang, Dong, Yongquan, Raychaudhury, Suchismita, White, Donna, Kramer, Jennifer R, Chiao, Elizabeth
Předmět:	HIV infection complications HIV-positive persons CONFIDENCE intervals LOG-rank test WOMEN RETROSPECTIVE studies RISK assessment T-test (Statistics) PAPILLOMAVIRUS diseases DESCRIPTIVE statistics CHI-squared test KAPLAN-Meier estimator VETERANS DATA analysis software STATISTICAL sampling WOMEN'S health FEMALE reproductive organ tumors LONGITUDINAL method DISEASE risk factors
Zdroj:	Clinical Infectious Diseases; 5/1/2021, Vol. 72 Issue 9, pe359-e366, 8p
Abstrakt:	Background Disparities in access to screening often confound observed differences in human papillomavirus (HPV)-associated female genital tract cancer (FGTC) incidence between women living with human immunodeficiency virus (HIV; WLWH) and their HIV-negative counterparts. We aimed to determine if there have been changes in cancer risk among WLWH during the antiretroviral era in a single-payer health system. Methods We retrospectively selected WLWH and HIV-negative controls receiving care between 1999 and 2016 at the US Department of Veterans Affairs (VA) and identified FGTC diagnoses via Cancer Registry and International Classification of Diseases-9/10 codes. We extracted demographic and clinical variables from the VA's Corporate Data Warehouse; evaluated incidence rates (IRs), incidence rate ratios, hazard ratios, and 95% confidence intervals (CIs) for cancer risk; and conducted survival analyses. Results We identified 1454 WLWH and compared them with 5816 matched HIV-negative controls. More WLWH developed HPV-associated FGTCs (total n = 28 [2.0%]; cervical = 22, vulvovaginal = 4, and anal/rectal = 2) than HIV-negative women (total n = 32 [0.6%]; cervical = 24, vulvovaginal = 5, and anal/rectal = 5) (log rank P <.0001). Cervical cancer IR was >6-fold higher for WLWH (204.2 per 100 000 person-years [py] [95% CI, 83.8–324.7]) than HIV-negative women (IR = 31.2 per 100 000 py [95% CI, 17.9–44.5]). The IRs for vulvovaginal and anal cancers were also higher in WLWH. Overall, WLWH were more likely to develop HPV-associated FGTCs compared with their HIV-negative counterparts (all log rank P values <.0001). Conclusions Veteran WLWH are more likely to develop HPV-associated FGTCs despite equal access to health care. Even in single-payer health systems, WLWH continue to require special attention to ensure guideline-based high-risk HPV screening for prevention of FGTCs. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
Externí odkaz:	Zobrazit plný text záznamu