Incidence of cervical high-grade squamous intraepithelial lesions in HIV-1-infected women with no history of cervical pathology: up to 17 years of follow-up

Sebastián Videla, Antoni Tarrats, Arelly Ornelas, Roger Badia, Eva Castella, Carme Alcalde, Anna Chamorro, José A. Esté, Bonaventura Clotet, Guillem Sirera

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Abstract

© The Author(s) 2018. Currently, Papanicolaou smears are proposed at three-year intervals for cervical screening to all women living with HIV. The aim of this retrospective cohort study was to provide data on the incidence of cervical high-grade squamous intraepithelial lesions (HSIL) in cervical smear confirmed by histology in HIV-1-infected women (two consecutive normal Papanicolaou smears at baseline) after a long-term follow-up. Sixty-seven women (recruited between March 1999 and January 2003) were analyzed. The median period of follow-up was 13.2 years (range: 7.4–17.1 years) with a total of 583 Papanicolaou smears. Twenty-seven percent of these HIV-1-infected women had poorly-controlled HIV. Cumulative incidence of HSIL was 18% (12/67; 95%CI: 11–29%) of which one was an invasive squamous cell carcinoma and two were carcinoma in situ. These women had not been well-engaged with the annual Papanicolaou smear screening program and had poor adherence to antiretroviral therapy. Development of HSIL was associated with high-risk-HPV infection (OR: 14.9; 95%CI: 3.0, 75.1). At last Papanicolaou smear, prevalence of high-risk-HPV infection was 30% (20/66, 95%CI: 21–42%). In conclusion, the incidence of cervical HSIL in HIV-1-infected women with poor antiretroviral therapy adherence or poor immunological status reinforces the need to identify those HIV-1-infected women at risk of developing cervical cancer.
Original languageEnglish
Pages (from-to)56-63
JournalInternational Journal of STD and AIDS
Volume30
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Cervical squamous intraepithelial lesions
  • HIV
  • HPV

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