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Prevalence and risk factors for human papillomavirus and cervical intraepithelial neoplasia among HIV-positive women at a tertiary level hospital in India.
J Low Genit Tract Dis. 2009 Jul; 13(3):159-64.JL

Abstract

OBJECTIVES

The hypothesis to be tested was that the prevalence of human papillomavirus (HPV) and cervical intraepithelial neoplasia would be significantly higher in HIV seropositive women as compared with seronegative controls. Secondary aims were to determine the risk factors for HPV and cervical intraepithelial neoplasia and the HPV types in HIV-positive women.

MATERIALS AND METHODS

A cross-sectional study of women 18 to 49 years old was done. Seventy-five women who were HIV seropositive and 58 seronegative women, of whom 27 had HIV-positive partners, participated in the study. A Pap smear and a cervical swab for HPV were done. Women with Pap smear abnormality underwent colposcopy and large loop excision procedures if indicated.

RESULTS

Ten (13.3%) HIV-positive women had high-grade squamous intraepithelial lesion as compared with 2 (3.4%) seronegative women (odds ratio [OR] 4.3; 95% CI = 0.9-41.7; p =.048). Among the HIV-positive women, 28 (37.3%) had high-risk HPV, whereas only 9 (15.5%) had high-risk HPV among seronegative women (OR 3.2; 95% CI = 1.3-8.3; p =.009). Among women who were positive for high-risk HPV, the HIV-positive women were significantly more likely to have more than 1 HPV type (OR 7.4; 95% CI = 1.4-43.7; p =.005). Women who had coitus at less than 18 years of age were more likely to have high-risk HPV infection (OR 2.9; 95% CI = 1.2-6.2; p =.013) even after controlling for HIV status.

CONCLUSIONS

HIV-positive women have a higher risk for multiple HPV infections as compared with seronegative women. Behavioral factors dominate HIV in determining HPV infections and resultant cervical neoplasia.

Authors+Show Affiliations

Department of Obstetrics & Gynaecology, Christian Medical College, Vellore, Tamilnadu, India. abraham@cmcvellore.ac.inNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19550213

Citation

Peedicayil, Abraham, et al. "Prevalence and Risk Factors for Human Papillomavirus and Cervical Intraepithelial Neoplasia Among HIV-positive Women at a Tertiary Level Hospital in India." Journal of Lower Genital Tract Disease, vol. 13, no. 3, 2009, pp. 159-64.
Peedicayil A, Thiyagarajan K, Gnanamony M, et al. Prevalence and risk factors for human papillomavirus and cervical intraepithelial neoplasia among HIV-positive women at a tertiary level hospital in India. J Low Genit Tract Dis. 2009;13(3):159-64.
Peedicayil, A., Thiyagarajan, K., Gnanamony, M., Pulimood, S. A., Jeyaseelan, V., Kannangai, R., Lionel, J., Abraham, O. C., & Abraham, P. (2009). Prevalence and risk factors for human papillomavirus and cervical intraepithelial neoplasia among HIV-positive women at a tertiary level hospital in India. Journal of Lower Genital Tract Disease, 13(3), 159-64. https://doi.org/10.1097/LGT.0b013e31818fb40d
Peedicayil A, et al. Prevalence and Risk Factors for Human Papillomavirus and Cervical Intraepithelial Neoplasia Among HIV-positive Women at a Tertiary Level Hospital in India. J Low Genit Tract Dis. 2009;13(3):159-64. PubMed PMID: 19550213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and risk factors for human papillomavirus and cervical intraepithelial neoplasia among HIV-positive women at a tertiary level hospital in India. AU - Peedicayil,Abraham, AU - Thiyagarajan,Kamala, AU - Gnanamony,Manu, AU - Pulimood,Susanne A, AU - Jeyaseelan,Visali, AU - Kannangai,Rajesh, AU - Lionel,Jessie, AU - Abraham,Oopurackal C, AU - Abraham,Priya, PY - 2009/6/25/entrez PY - 2009/6/25/pubmed PY - 2009/9/16/medline SP - 159 EP - 64 JF - Journal of lower genital tract disease JO - J Low Genit Tract Dis VL - 13 IS - 3 N2 - OBJECTIVES: The hypothesis to be tested was that the prevalence of human papillomavirus (HPV) and cervical intraepithelial neoplasia would be significantly higher in HIV seropositive women as compared with seronegative controls. Secondary aims were to determine the risk factors for HPV and cervical intraepithelial neoplasia and the HPV types in HIV-positive women. MATERIALS AND METHODS: A cross-sectional study of women 18 to 49 years old was done. Seventy-five women who were HIV seropositive and 58 seronegative women, of whom 27 had HIV-positive partners, participated in the study. A Pap smear and a cervical swab for HPV were done. Women with Pap smear abnormality underwent colposcopy and large loop excision procedures if indicated. RESULTS: Ten (13.3%) HIV-positive women had high-grade squamous intraepithelial lesion as compared with 2 (3.4%) seronegative women (odds ratio [OR] 4.3; 95% CI = 0.9-41.7; p =.048). Among the HIV-positive women, 28 (37.3%) had high-risk HPV, whereas only 9 (15.5%) had high-risk HPV among seronegative women (OR 3.2; 95% CI = 1.3-8.3; p =.009). Among women who were positive for high-risk HPV, the HIV-positive women were significantly more likely to have more than 1 HPV type (OR 7.4; 95% CI = 1.4-43.7; p =.005). Women who had coitus at less than 18 years of age were more likely to have high-risk HPV infection (OR 2.9; 95% CI = 1.2-6.2; p =.013) even after controlling for HIV status. CONCLUSIONS: HIV-positive women have a higher risk for multiple HPV infections as compared with seronegative women. Behavioral factors dominate HIV in determining HPV infections and resultant cervical neoplasia. SN - 1526-0976 UR - https://www.unboundmedicine.com/medline/citation/19550213/Prevalence_and_risk_factors_for_human_papillomavirus_and_cervical_intraepithelial_neoplasia_among_HIV_positive_women_at_a_tertiary_level_hospital_in_India_ L2 - https://doi.org/10.1097/LGT.0b013e31818fb40d DB - PRIME DP - Unbound Medicine ER -