HIV and human papillomavirus as independent risk factors for cervical neoplasia in women with high or low numbers of sex partners

• Published in: Sexually transmitted infections 1999-08, Vol.75 (4), p.258-260
• Main Authors: Vernon, S D, Unger, E R, Piper, M A, Severin, S T, Wiktor, S Z, Ghys, P D, Miller, D L, Horowitz, I R, Greenberg, A E, Reeves, W C
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; AIDS/HIV; Biological and medical sciences; Case-Control Studies; CD4 Lymphocyte Count; Cervical Intraepithelial Neoplasia - immunology; Cervical Intraepithelial Neoplasia - virology; Cote d'Ivoire; Cross-Sectional Studies; DNA, Viral - analysis; Female; HIV Infections - complications; HIV Infections - immunology; HIV-1 - genetics; HIV-2 - genetics; Human viral diseases; Humans; Infectious diseases; Medical sciences; Middle Aged; Odds Ratio; Original; Papillomaviridae - genetics; Papillomavirus Infections - complications; Papillomavirus Infections - immunology; Risk Factors; Sex Work; Tumor Virus Infections - complications; Tumor Virus Infections - immunology; Uterine Cervical Neoplasms - immunology; Uterine Cervical Neoplasms - virology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids
• ISSN: 1368-4973; 1472-3263
• DOI: 10.1136/sti.75.4.258

OBJECTIVE: To explore whether HIV types 1 and 2 and CD4 cell count affect cervical neoplasia independent of human papillomavirus (HPV) in women with high or low numbers of sexual partners residing in Abidjan, Côte d'Ivoire. METHODS: The study population and methods are described in the companion paper. Additional methods include a Papanicolaou smear for cytological diagnosis and statistical analysis. RESULTS: In maternal women, both HIV-1 and high risk HPV were significant independent risk factors for squamous intraepithelial lesions (SIL) (adjusted odds ratio (OR) 11.0 (95% CI 1.1-112) and 5.4 (1.5-18.8), respectively). Only high levels of HPV DNA in the lavage were associated with SIL (OR 13.2 (3.6-47.8)) in the maternal group. In female sex workers, high risk HPV was significantly associated with SIL (OR 23.7 (4.4-126)); HIV seropositivity was not. Any positive level (high or low amounts) of HPV DNA was significantly associated with SIL in sex workers (ORs 15.9 (3.3-76) and 12.7 (3.6-44), respectively). There was no association of SIL with CD4 cell counts < or = 500 x 10(6)/l in HIV seropositive women from either group. CONCLUSION: HPV or HIV-1 infection independently affect cervical neoplasia in women with low numbers of sex partners.