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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Human papillomavirus infection and cervical disease in human immunodeficiency virus-1-infected women
Obstetrics and Gynecology, Volume 111, No. 6, Year 2008
Notification
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Description
OBJECTIVE:: To report on the natural history of high-risk human papillomavirus (HPV) infection and cervical disease in human immunodeficiency virus (HIV)-1-infected women living in Cape Town, South Africa. METHODS:: This was a prospective study of 400 untreated, HIV-1-infected women who underwent high-risk HPV DNA testing, cytology, colposcopy, histology, and CD4 count testing every 6 months for 36 months. Human immunodeficiency virus viral loads and HPV type distribution were determined at entry and after 18 months. RESULTS:: Sixty-eight percent of the women were high-risk HPV DNA positive at entry, 35% had a cytologic diagnosis of low-grade squamous intraepithelial lesion (LSIL), and 13% had high-grade squamous intraepithelial lesion (HSIL). There were no cancers. Abnormal cytology and high-risk HPV positivity were strongly correlated with low CD4 counts and high HIV viral loads. The most prevalent types of HPV were HPV-16, -52, -53, -35, and -18. Incident high-risk HPV infection occurred in 22%, and of those infected with high-risk HPV, 94% of infections persisted over an 18-month period, and 6% cleared their infections. Cytologic progression to SIL from normal/atypical squamous cells of undetermined significance cytology occurred in 17% of cases, but only 4% of cases of LSIL progressed to HSIL. CONCLUSION:: There is a high level of high-risk HPV infection in HIV-1 infected women, but progression to HSIL over 36 months occurred in the minority of cases. We recommend an initial colposcopy for an abnormal test, and if no high-grade lesion is identified, triennial screening would be appropriate. Human papillomavirus type 16 was the commonest, and HPV-18 was the fifth commonest, suggesting that vaccination against these two types would have a significant effect. © 2008 by The American College of Obstetricians and Gynecologists.
Authors & Co-Authors
Denny, Lynette A.
South Africa, Cape Town
University of Cape Town
South Africa, Observatory
Groote Schuur Hospital
Boa, Ros
Unknown Affiliation
Williamson, Anna Lise
Unknown Affiliation
Allan, Bruce Rider
Unknown Affiliation
Hardie, Diane
Unknown Affiliation
Stan, Ress
Unknown Affiliation
Myer, Landon
Unknown Affiliation
Statistics
Citations: 136
Authors: 7
Affiliations: 2
Identifiers
Doi:
10.1097/AOG.0b013e3181743327
ISSN:
00297844
Research Areas
Cancer
Genetics And Genomics
Infectious Diseases
Study Design
Cohort Study
Study Locations
South Africa
Participants Gender
Female