Increased risk of high-grade cervical squamous intraepithelial lesions and invasive cervical cancer among African women with human immunodeficiency virus type 1 and 2 infections
Increased risk of high-grade cervical squamous intraepithelial lesions and invasive cervical cancer among African women with human immunodeficiency virus type 1 and 2 infections
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DOI：
10.1086/376996
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发表时间：
2003-08-15
影响因子：
6.4
通讯作者：
Kiviat, NB
中科院分区：
文献类型：
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作者：
Hawes, SE;Critchlow, CW;Kiviat, NB
为了评估与人类免疫缺陷病毒 (HIV) 1 型、HIV-2 和人乳头瘤病毒 (HPV) 感染、HIV 载量和 CD4 细胞计数相关的流行的高级宫颈鳞状上皮内病变 (HSIL) 或浸润性宫颈癌 (ICC) 的风险，我们对塞内加尔门诊部就诊的 4119 名女性进行了研究。 HIV 感染与高危 HPV 宫颈感染率增加相关。在感染高危 HPV 的女性中，HIV-1（比值比 [OR]，2.2；95% 置信区间 [CI]，1.0-4.8）、HIV-2（OR，6.0；95% CI，2.1-17.1）或双重 HIV 感染（OR，8.0；95% CI，2.0-31.5）的女性更有可能患有 HSIL 或ICC 诊断结果高于 HIV 阴性女性；在未感染高危 HPV 的女性中未观察到这种关联。在感染 HIV 的女性中，较高的 HIV 血浆 RNA 载量和较低的 CD4 细胞计数与高危 HPV 感染和宫颈异常程度相关。此外，与 HIV-1 阳性女性相比，HIV-2 阳性女性更有可能患有 HSIL（OR，3.3；95% CI，0.9-12.4）或 ICC（OR，7.9；95% CI，1.1-57）。
To assess the risk of prevalent high-grade cervical squamous intraepithelial lesions (HSILs) or invasive cervical cancer (ICC) associated with human immunodeficiency virus (HIV) type 1, HIV-2, and human papillomavirus (HPV) infections, HIV load, and CD4 cell count, we studied 4119 women attending an outpatient clinic in Senegal. HIV infection was associated with increased rates of cervical infection with high-risk HPVs. Among women infected with high-risk HPVs, those with HIV-1 (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.0-4.8), HIV-2 (OR, 6.0; 95% CI, 2.1-17.1), or dual HIV infection (OR, 8.0; 95% CI, 2.0-31.5) were more likely to have HSILs or ICC diagnosed than were HIV-negative women; this association was not observed among women not infected with high-risk HPVs. Among women with HIV, higher HIV plasma RNA loads and lower CD4 cell counts were associated with high-risk HPV infection and degree of cervical abnormality. Furthermore, HIV-2-positive women were more likely to have HSILs (OR, 3.3; 95% CI, 0.9-12.4) or ICC (OR, 7.9; 95% CI, 1.1-57) than were HIV-1-positive women.