Higher Prevalence of Human Papillomavirus-Related Cervical Precancerous Abnormalities in HIV-Infected Compared to HIV-Uninfected Women
| Autor: | Vernita A. Tucker, Gwinnett Ladson, Natasha A. Choudhury, Sten H. Vermund, Shahana A. Choudhury, Vladimir Berthaud, Ammie D. Humphrey |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Adolescent Human immunodeficiency virus (HIV) Uterine Cervical Neoplasms HIV Infections Comorbidity medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Hiv infected medicine Prevalence Humans 030212 general & internal medicine Human papillomavirus Cervix Papillomaviridae Gynecology business.industry Obstetrics Medical record Papillomavirus Infections virus diseases Cancer General Medicine medicine.disease Tennessee Health equity medicine.anatomical_structure 030220 oncology & carcinogenesis Cohort Female business |
| Zdroj: | Journal of the National Medical Association. 108(1) |
| ISSN: | 0027-9684 |
| Popis: | Persistent high risk human papillomavirus (hrHPV) has been associated with cervical abnormalities and cancer. There are few studies comparing HIV-infected with uninfected African American women from the Southern U.S. We evaluated medical records of a women's cohort in an urban clinic in Tennessee to assess the prevalence of hrHPV and cytology correlates, as well as HPV vaccination rates.We reviewed medical records of 50 HIV infected and 304 HIV uninfected women, including Pap smears and hrHPV.HIV-infected women were older than HIV-uninfected women (p0.0001) and were more likely to have hrHPV (p=0.0001) and LGSIL/HGSIL (p=0.006). Within the HIV uninfected group, Hispanic women were younger than non-Hispanic African American women (p=0.04) and non-Hispanic white women (p=0.0002). Non-Hispanic African-American women were younger (p=0.004) than non-Hispanic white women. Both HIV-uninfected and HIV-infected women had an 11-fold and 5-fold odds, respectively, of having precancerous lesions when harboring hrHPV, compared to hrHPV-uninfected women. Of the 125 HIV-uninfected women, only 17% had received at least one dose of the HPV vaccine. None of the 21 vaccine recipients had evidence of SILs compared to 9% of vaccine non-recipients (p=0.35, Fisher's exact test).HIV-infected women remained at significantly higher risk for developing cervical precancerous lesions when exposed to hrHPV than their uninfected counterparts. Hispanic women were least likely to have been vaccinated. Missed HPV vaccination trended towards being associated with a higher odds of precancerous lesions. Routine HPV vaccination should be reinforced for adolescents and young women using public hospital facilities of all races and ethnic backgrounds. |
| Databáze: | OpenAIRE |
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