Original articleIncreased risk of cervical disease among human immunodeficiency virus–infected women with severe immunosuppression and high human papillomavirus load1☆,
Section snippets
Materials and methods
Between June 1993 and February 1996, 307 HIV-seropositive women attending the outpatient clinics of Hôpital Broussais and the Department of Obstetrics and Gynecology of Hôpital Cochin, Paris, were enrolled in a prospective study of cervical disease in HIV-seropositive women. The protocol was reviewed and approved by the French National Agency for AIDS Research. All women gave informed consent to participate in the study and were interviewed using a standardized questionnaire with questions
Results
The women included in the study were aged between 19 and 72 years, with a median age of 32 years. Two hundred twelve women (69%) were white, 80 (26%) were black or Caribbean, and the remaining 15 had various ethnic backgrounds. The mode of HIV transmission was heterosexual contact in 184 women (60%), intravenous drug use in 90 (29%), transfusion of contaminated blood products in 14 (5%), and unknown in 19 (6%). Seventy-seven women had histories of abnormal Papanicolaou smears (44 [14.3%] had
Discussion
In this series of 307 HIV-seropositive women, a high prevalence (27%) of biopsy-confirmed cervical disease was observed, in agreement with previous reports.8, 10 A proportion of the women (18.2%) could not undergo biopsies despite abnormal Papanicolaou smears and/or minor colposcopic lesions, suggesting that the overall prevalence of CIN may have been underestimated. A high prevalence of HPV infection (52.8%) was noted in our study population when PCR and Southern blot hybridization data were
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Cited by (0)
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This study was supported by INSERM, the Agence Nationale de Recherches sur le SIDA, and SIDACTION, France.
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The authors are grateful to J.-D. Poveda (Centre de Biologie Médicale Spécialisée, Institut Pasteur) for his help with human papillomavirus typing.