Changes in HIV-Related Cervical Cancer Over a Decade in Côte d'Ivoire
| Autor: | Didier K. Ekouevi, Isidore Diomande, Judith Didi-Kouko Coulibaly, Kouassi Comoe, Boris Tchounga, Innocent Adoubi, Simon Boni, Apollinaire Horo, Antoine Jaquet, Aristophane Tanon |
|---|---|
| Přispěvatelé: | Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Félix Houphouët-Boigny (UFHB), Université de Lomé [Togo] |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Invasive cervical cancer Human immunodeficiency virus (HIV) Uterine Cervical Neoplasms HIV Infections [SDV.CAN]Life Sciences [q-bio]/Cancer Cote d ivoire [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Pregnancy [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases medicine Humans 030212 general & internal medicine Cervical cancer Gynecologic Cancer Obstetrics business.industry ORIGINAL REPORTS medicine.disease CD4 Lymphocyte Count 3. Good health Cote d'Ivoire Cross-Sectional Studies Oncology 030220 oncology & carcinogenesis Female [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie business |
| Zdroj: | JCO Global Oncology JCO Global Oncology, American Society of Clinical Oncology, 2021, 7, pp.782-789. ⟨10.1200/go.21.00006⟩ |
| ISSN: | 2687-8941 |
| DOI: | 10.1200/go.21.00006 |
| Popis: | PURPOSE Major improvements have occurred in access to invasive cervical cancer (ICC) screening in HIV-infected women over the past decade in sub-Saharan Africa. However, there is limited information on changes in the burden of HIV-related ICC at a population level. Our objective was to compare HIV-related ICC over a decade and document factors associated with HIV infection in women with ICC in Côte d'Ivoire. METHODS A repeated cross-sectional study was conducted in referral hospitals of Abidjan, Côte d'Ivoire, through the 2009-2011 and 2018-2020 periods. Women diagnosed with ICC were systematically tested for HIV. Demographics, ICC risk factors, cancer stage (International Federation of Gynecology and Obstetrics), and HIV characteristics were collected through questionnaires. Characteristics of HIV-related ICC were compared between the periods, and factors associated with HIV in women diagnosed with ICC in 2018-2020 were documented through a multivariable logistic model. RESULTS During the 2009-2011 and 2018-2020 periods, 147 and 297 women with ICC were diagnosed with estimated HIV prevalence of 24.5% and 21.9% ( P = .53), respectively. In HIV-infected women, access to antiretroviral treatment increased from 2.8% to 73.8% ( P < 10−4) and median CD4 cell count from 285 (IQR, 250-441) to 492 (IQR, 377-833) cells/mm3 ( P = .03). In women diagnosed with ICC during the 2018-2020 period, HIV infection was associated with a less advanced clinical stage (International Federation of Gynecology and Obstetrics I or II stage) (adjusted OR, 2.2 [95% CI, 1.1 to 4.4]) and with ICC diagnosis through a systematic screening (adjusted OR, 10.5 [95% CI, 2.5 to 45.5]). CONCLUSION Despite a persistently high proportion of HIV-related ICC over time in Côte d'Ivoire, HIV was associated with less advanced clinical stage at ICC diagnosis. Recent improvements in ICC screening services across HIV clinics might explain this association and support their implementation across non-HIV health facilities. |
| Databáze: | OpenAIRE |
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