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Incidence of cervical intraepithelial neoplasia in a cohort of HIV‐infected women
Author(s) -
Araújo Angela C.L.,
Carvalho Nara O.,
Teixeira Nara C.,
Souza Tatiana T.,
Murta Érica D.,
Faria Iwens M.,
Corrêa Christine M.,
Lima Maria I.M.,
del Castillo Dora M.,
Melo Victor H.
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.12.024
Subject(s) - medicine , incidence (geometry) , cervical intraepithelial neoplasia , obstetrics , gynecology , cohort , retrospective cohort study , relative risk , cohort study , cervical cancer , cancer , confidence interval , physics , optics
Objective To assess cervical intraepithelial neoplasia (CIN) incidence in HIV‐positive women and the risk factors for these lesions. Methods A retrospective and longitudinal cohort study was conducted from June 13, 1997, to December 18, 2009. At the first visit, the 348 participants had a normal cytologic finding but a negative Schiller test result, or an abnormal cytologic finding but no histologic diagnosis of CIN. Infection with HPV was detected by polymerase chain reaction. The main outcome measure was CIN incidence. Results During a mean follow‐up of 40 months, 47 women (13.5%) developed CIN, for an incidence of 4.1 cases per 100 person‐years of follow‐up. The HPV prevalence was 68.1%, 42 women (89.4%) developed CIN 1, and no invasive cervical cancers were identified. On multivariate analysis, women younger than 19 years at first sexual intercourse (RR, 2.6; 95% CI, 1.24–5.35) and women who had never used antiretrovirals or used them only during pregnancy (RR, 2.3; 95% CI, 1.31–4.19) were at higher risk for CIN. Conclusion The CIN incidence was low despite the high HPV prevalence. Being younger than 19 years at first sexual intercourse and not using antiretroviral medications were found to be the main risk factors for CIN.