TY - JOUR
T1 - Cervical intraepithelial neoplasia in women infected with human immunodeficiency virus
T2 - Prevalence, risk factors, and validity of papanicolaou smears
AU - Wright, Thomas C.
AU - Ellerbrock, Tedd V.
AU - Chiasson, Mary Ann
AU - Devanter, Nancy Van
AU - Sun, Xiao Wei
AU - The New York Cervical Disease Study, New York Cervical Disease Study
AU - Brudney, Karen
AU - Dole, Pamela
AU - Koulos, John
AU - Richart, Ralph
AU - Young, Susan
AU - Bush, Tim
AU - Johnson, Edward
AU - Perez, George
AU - Marte, Carola
PY - 1994/10
Y1 - 1994/10
N2 - Objective: To define the prevalence of cervical intraepithelial neoplasia (CIN), the validity of Papanicolaou tests, and the associations between CIN and risk factors for cervical disease in human immunodeficiency virus (HIV)-infected women. Methods: In this cross-sectional study, we enrolled 398 HIV-seropositive and 357 HIV-seronegative women from two HIV-AIDS clinics, two sexually transmitted disease clinics, a methadone clinic, and a clinic for participants in an HIV heterosexual transmission study. Each woman was interviewed and underwent a cytologic and colposcopic evaluation, and was tested for human papillomavirus (HPV) DNA. Results: Eighty (20%) of the 398 HIV-seropositive women compared to 15 (4%) of the 357 seronegative women had colposcopically confirmed CIN (odds ratio 5.7; P <.001). No invasive cancers were found. The sensitivity and specificity of Papanicolaou tests in seropositive women were 81 and 87%, respectively. By multiple logistic regression analysis using a model that included behavioral and biologic risk factors for CIN, CIN was independently associated with HPV infection (odds ratio 9.8), HIV infection (odds ratio 3.5), CD4+ T-lymphocyte count less than 200 cells/μL (odds ratio 2.7), and age greater than 34 years (odds ratio 2.0). Conclusions: Cervical intraepithelial neoplasia is a common finding in HIV-infected women. However, the results of this study suggest that Papanicolaou tests should be effective for detecting cervical disease in this population.
AB - Objective: To define the prevalence of cervical intraepithelial neoplasia (CIN), the validity of Papanicolaou tests, and the associations between CIN and risk factors for cervical disease in human immunodeficiency virus (HIV)-infected women. Methods: In this cross-sectional study, we enrolled 398 HIV-seropositive and 357 HIV-seronegative women from two HIV-AIDS clinics, two sexually transmitted disease clinics, a methadone clinic, and a clinic for participants in an HIV heterosexual transmission study. Each woman was interviewed and underwent a cytologic and colposcopic evaluation, and was tested for human papillomavirus (HPV) DNA. Results: Eighty (20%) of the 398 HIV-seropositive women compared to 15 (4%) of the 357 seronegative women had colposcopically confirmed CIN (odds ratio 5.7; P <.001). No invasive cancers were found. The sensitivity and specificity of Papanicolaou tests in seropositive women were 81 and 87%, respectively. By multiple logistic regression analysis using a model that included behavioral and biologic risk factors for CIN, CIN was independently associated with HPV infection (odds ratio 9.8), HIV infection (odds ratio 3.5), CD4+ T-lymphocyte count less than 200 cells/μL (odds ratio 2.7), and age greater than 34 years (odds ratio 2.0). Conclusions: Cervical intraepithelial neoplasia is a common finding in HIV-infected women. However, the results of this study suggest that Papanicolaou tests should be effective for detecting cervical disease in this population.
UR - http://www.scopus.com/inward/record.url?scp=0028088520&partnerID=8YFLogxK
M3 - Article
C2 - 8090399
AN - SCOPUS:0028088520
SN - 0029-7844
VL - 84
SP - 591
EP - 597
JO - Obstetrics and Gynecology
JF - Obstetrics and Gynecology
IS - 4
ER -