The association between HIV infection, antiretroviral therapy and cervical squamous intraepithelial lesions in South Western Nigerian women.
The association between HIV infection, antiretroviral therapy and cervical squamous intraepithelial lesions in South Western Nigerian women.
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DOI：
10.1371/journal.pone.0097150
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Ostergren PO
中科院分区：
文献类型：
--
作者：
Ezechi OC;Pettersson KO;Okolo CA;Ujah IA;Ostergren PO
评估抗逆转录病毒药物使用对宫颈鳞状上皮内病变发展的影响的研究结果不同于他们的结论。这项研究调查了在艾滋病毒和宫颈癌负担较高的尼日利亚，艾滋病毒感染、抗逆转录病毒药物使用和宫颈鳞状上皮内病变之间的关系。在一项随机研究中，对1140名已知HIV感染状况的妇女进行了一项横断面研究，以确定目视检查在检测细胞学诊断为鳞状上皮内病变方面的测试特征。在控制混杂因素的同时，采用多因素分析来确定HIV感染、抗逆转录病毒药物的使用与宫颈鳞状上皮内病变(SIL)和高度鳞状上皮内病变(HSIL)的双变量结局之间的关系。宫颈鳞状上皮内病变的患病率为8.5%，其中HIV阳性妇女的患病率为14.3%，高于HIV阴性妇女的3.3%(AOR：5.4；95%CI：2.9-8.8)。未使用抗逆转录病毒药物与SLE(AOR：2.1；95%CI：1.4-3.5)和HSIL(AOR：2.6；95%CI：1.1-6.4)的风险增加相关。研究还发现，CD4细胞计数为200个/mm~3的受试者罹患系统性红斑狼疮(AOR：1.9；95%CI：1.1-5.9)和HSIL(AOR：5.7；95%CI：1.1-7.2)的风险增加。HIV感染和严重的免疫抑制被发现与宫颈鳞状上皮内病变的风险增加有关，但与病毒载量无关。首次在具有特定HIV类型和毒株的西非次区域，我们建立了抗逆转录病毒药物使用对SLE发展的保护作用。因此，将宫颈癌筛查方案纳入艾滋病毒服务，并在艾滋病毒阳性妇女，特别是免疫功能严重受抑的妇女中及早开始使用抗逆转录病毒药物，可证明有助于预防和控制艾滋病毒阳性妇女的宫颈癌发展。
Findings from studies that evaluated the effect of antiretroviral drug use on the development of cervical squamous intraepithelial lesion differed in their conclusions. This study investigated the association between HIV infection, antiretroviral drug use and cervical squamous intraepithelial lesion in a high HIV and cervical cancer burden setting- Nigeria. A cross sectional study among 1140 women of known HIV status enrolled in a randomised study to determine the test characteristics of visual inspection in detecting cytology diagnosed squamous intraepithelial lesion. Multivariate analysis was used to determine the association between HIV infection, antiretroviral drug use and the twin outcome variables of cervical squamous intraepithelial lesion (SIL) and High grade squamous intraepithelial lesion (HSIL) while controlling for confounders. Prevalence of cervical squamous intraepithelial lesion was 8.5%, with a higher prevalence of 14.3% in HIV positive compared to 3.3% in HIV negative women (aOR: 5.4; 95% CI: 2.9–8.8). Not using antiretroviral drugs was found to be associated with an increased risk of SIL (aOR: 2.1; 95% CI: 1.4–3.5) and HSIL (aOR: 2.6; 95% CI: 1.1–6.4). Participants who had a CD4 cell count <200 cells/mm3, were also found to be at increased risk for SIL (aOR: 1.9; 95% CI: 1.1–5.9) and HSIL (aOR: 5.7; 95% CI: 1.1–7.2). HIV infection and severe immunosuppression were found to be associated with increased risk of cervical squamous intraepithelial lesion but not viral load. For the first time, in the West African sub-region with specific HIV type and strains, we established the protective effect of antiretroviral drug use against the development of SIL. Integration of cervical cancer screening programme into HIV services and early initiation of antiretroviral drug in HIV positive women especially those with severe immune-suppression could therefore prove to be useful in preventing and controlling cervical cancer development in HIV positive women.
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DOI：
10.1016/j.ijgo.2009.06.006
发表时间：
2009-11-01
影响因子：
3.8
作者：
Agaba, Patricia A.;Thacher, Thomas D.;Idoko, John A.
通讯作者：
Idoko, John A.
影响因子：
7.5
作者：
Jevtovic, Djordje;Dragovic, Gordana;Djurkovic-Djakovic, Olgica
通讯作者：
Djurkovic-Djakovic, Olgica
影响因子：
6
作者：
Firnhaber, Cynthia;Westreich, Daniel;Smith, Jennifer S.
通讯作者：
Smith, Jennifer S.
影响因子：
6.4
作者：
Banura, Cecily;Franceschi, Silvia;Weiderpass, Elisabete
通讯作者：
Weiderpass, Elisabete
DOI：
10.1080/01443610310000100114
发表时间：
2003-05-01
期刊：
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
影响因子：
--
作者：
Anorlu, Rose I;Abdul-Kareem, Fatima B;Oyekan, Tinuola O
通讯作者：
Oyekan, Tinuola O