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. 2016 Mar;27(3):219-25.
doi: 10.1177/0956462415584466. Epub 2015 May 7.

Prevalence and risk factors of cervical squamous intraepithelial lesions among HIV-infected women in Dar es Salaam, Tanzania

Enju Liu  1 , Renicha McCree  2 , Expeditho Mtisi  3 , Wafaie W Fawzi  4 , Eric Aris  5 , Irene A Lema  5 , Ellen Hertzmark  6 , Guerino Chalamilla  5 , Nan Li  1 , Sten H Vermund  7 , Donna Spiegelman  8
Affiliations

Prevalence and risk factors of cervical squamous intraepithelial lesions among HIV-infected women in Dar es Salaam, Tanzania

Enju Liu et al. Int J STD AIDS. 2016 Mar.

Abstract

To determine the prevalence and predictors of cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Tanzania, a cross-sectional study was conducted among HIV-infected women at HIV care and treatment clinics. A Papanicolaou (Pap) smear was used as a screening tool for detection of cervical SIL. From December 2006 to August 2009, 1365 HIV-infected women received cervical screening. The median age was 35 (interquartile range [IQR]: 30-42) years, and the median CD4 + cell count was 164 (IQR: 80-257) cells/mm(3). The prevalence of cervical SIL was 8.7% (119/1365). In multivariate analysis, older age (≥50 versus 30-<40 years: prevalence ratio [PR], 2.36; 95% confidence interval [CI], 1.45-3.84, p for trend = 0.001), lower CD4 + cell counts (<100 versus ≥200 cells/mm(3): PR, 1.55; 95% CI, 1.01-2.36, p for trend = 0.03) and cervical inflammation (PR, 1.73; 95% CI, 1.16-2.60, p = 0.008) were associated with an increased risk of cervical SIL. Women with advanced WHO HIV disease stage (IV versus I/II: PR, 3.45; 95% CI, 1.35-8.85, p for trend = 0.01) had an increased risk for high-grade SIL. In resource-limited settings where it is not feasible to provide cervical cancer prevention services to all HIV-infected women, greater efforts should focus on scaling-up services among those who are older than 50 years, with lower CD4 cell counts and advanced HIV disease stage.

Keywords: AIDS; HIV; HIV-infected women; HPV; Papanicolaou (Pap) smear; Tanzania; cervical squamous intraepithelial lesions; human papillomavirus; prevalence; risk factors.

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Conflict of interest statement

Declaration of conflicting interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Walboomers JM, Jacobs MV, Manos MM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189: 12–19. - PubMed
    1. Sun XW, Kuhn L, Ellerbrock TV, et al. Human papillomavirus infection in women infected with the human immunodeficiency virus. N Engl J Med 1997; 337: 1343–1349. - PubMed
    1. Franceschi S and Ronco G. The prevention of cervical cancer in HIV-infected women. AIDS 2010; 24: 2579–2580. - PubMed
    1. Horo A, Jaquet A, Ekouevi DK, et al. Cervical cancer screening by visual inspection in Cote d’Ivoire, operational and clinical aspects according to HIV status. BMC Public Health 2012; 12: 237. - PMC - PubMed
    1. Ramogola-Masire D, de Klerk R, Monare B, et al. Cervical cancer prevention in HIV-infected women using the “see and treat” approach in Botswana. J Acquir Immune Defic Syndr 2012; 59: 308–313. - PMC - PubMed

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