Women With HIV Have Higher Cervical Cancer Progression
Adverse transition was associated with HPV-16/18 and CD4-positive count < 200/mm.
Women with HIV are more likely to experience progressive cervical changes, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.
The study evaluated 1320 women from Senegal, West Africa between 1994 and 2010. Cytology by Pap smear and human papillomavirus (HPV) DNA testing were conducted at approximately 4-month intervals.
The median age at baseline was 35 and 47% of patients were HIV-positive. The baseline cervical natural history stage was normal in 36.1%, HPV-positive in 58.5%, and high-grade squamous intraepithelial lesions (HSIL) were present in 5.4%.
Women who were HIV-positive had a higher risk of cervical adverse transition compared with patients who were HIV-negative, including from HPV to HSIL (HR, 2.55; 95% CI, 1.69 to 3.86; P <.0001). Adverse transition was associated with HPV-16/18 and CD4-positive count <200/mm3.
Infection with HIV-1 was associated with a greater incidence rate of HPV detection and cervical progression from HPV to HSIL compared with HIV-2 infection, with and without adjustment for age and CD4-positive count.
According to the authors, these results can “be used to inform the eventual implementation of comprehensive population-based screening paradigms that are not yet widely available in the limited resource setting of sub-Saharan Africa.”
Whitham HK, Hawes SE, Chu H, et al. A comparison of the natural history of HPV infection and cervical abnormalities among HIV-positive and HIV-negative women in Senegal, Africa. Cancer Epidemiol Biomarkers Prev. 2017;26:886-94 doi: 10.1158/1055-9965.EPI-16-0700