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Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up
Background: Women living with Human Immunodeficiency Virus are at higher risk of cervical cancer and precancer compared to women without HIV infection. The aim of the study is to evaluate the risk factors for the development of CIN2+ in a cohort of WLWH with negative colposcopy and cytology during a...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961029/ https://www.ncbi.nlm.nih.gov/pubmed/36851143 http://dx.doi.org/10.3390/vaccines11020265 |
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author | Gardella, Barbara Agarossi, Alberto Dominoni, Mattia Pagano, Isabella Del Frati, Susanna Di Giminiani, Maria Cammarata, Selene Melito, Chiara Pasquali, Marianna Francesca Zanchi, Lucia Savasi, Valeria Spinillo, Arsenio |
author_facet | Gardella, Barbara Agarossi, Alberto Dominoni, Mattia Pagano, Isabella Del Frati, Susanna Di Giminiani, Maria Cammarata, Selene Melito, Chiara Pasquali, Marianna Francesca Zanchi, Lucia Savasi, Valeria Spinillo, Arsenio |
author_sort | Gardella, Barbara |
collection | PubMed |
description | Background: Women living with Human Immunodeficiency Virus are at higher risk of cervical cancer and precancer compared to women without HIV infection. The aim of the study is to evaluate the risk factors for the development of CIN2+ in a cohort of WLWH with negative colposcopy and cytology during a long follow-up period. Methods: We enrolled, in a multicentric retrospective cohort study, WLWH who attended the colposcopic services from 1999 to 2019. Patients with a normal Pap smear, a negative HR-HPV test, and at least one year of follow-up were considered for the anlysis. Results: The five-year cumulative incidence of histologically confirmed HSIL was 8.3% (95% CI = 2.6–13.6) among subjects with a CD4+ cell count of <200 cells/µL at any visit and 2.1% (95% CI = 0.7–3.4, p = 0.001) in women with a CD4+ cell count of persistently >200 cells/µL. In women with persistent HR-HPV infection, the five-year cumulative incidence of CIN 2+ was 6% (95% CI = 1.6–10.2) versus 2% (95% CI = 0.4–3.6, p = 0.012) in women without HPV infection. An HIV viremia of >200 copies/mL, a CD4+ cell count of <200 cells/µL, persistent HR-HPV infection, and smoking ≥10 cigarettes/day were all independent and statistically significant risk factors associated with the development of CIN2+ during follow-up. Conclusions: WLWH with good immune status and negative Pap smear and HR-HPV test have a low risk for CIN2+. |
format | Online Article Text |
id | pubmed-9961029 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-99610292023-02-26 Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up Gardella, Barbara Agarossi, Alberto Dominoni, Mattia Pagano, Isabella Del Frati, Susanna Di Giminiani, Maria Cammarata, Selene Melito, Chiara Pasquali, Marianna Francesca Zanchi, Lucia Savasi, Valeria Spinillo, Arsenio Vaccines (Basel) Article Background: Women living with Human Immunodeficiency Virus are at higher risk of cervical cancer and precancer compared to women without HIV infection. The aim of the study is to evaluate the risk factors for the development of CIN2+ in a cohort of WLWH with negative colposcopy and cytology during a long follow-up period. Methods: We enrolled, in a multicentric retrospective cohort study, WLWH who attended the colposcopic services from 1999 to 2019. Patients with a normal Pap smear, a negative HR-HPV test, and at least one year of follow-up were considered for the anlysis. Results: The five-year cumulative incidence of histologically confirmed HSIL was 8.3% (95% CI = 2.6–13.6) among subjects with a CD4+ cell count of <200 cells/µL at any visit and 2.1% (95% CI = 0.7–3.4, p = 0.001) in women with a CD4+ cell count of persistently >200 cells/µL. In women with persistent HR-HPV infection, the five-year cumulative incidence of CIN 2+ was 6% (95% CI = 1.6–10.2) versus 2% (95% CI = 0.4–3.6, p = 0.012) in women without HPV infection. An HIV viremia of >200 copies/mL, a CD4+ cell count of <200 cells/µL, persistent HR-HPV infection, and smoking ≥10 cigarettes/day were all independent and statistically significant risk factors associated with the development of CIN2+ during follow-up. Conclusions: WLWH with good immune status and negative Pap smear and HR-HPV test have a low risk for CIN2+. MDPI 2023-01-26 /pmc/articles/PMC9961029/ /pubmed/36851143 http://dx.doi.org/10.3390/vaccines11020265 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Gardella, Barbara Agarossi, Alberto Dominoni, Mattia Pagano, Isabella Del Frati, Susanna Di Giminiani, Maria Cammarata, Selene Melito, Chiara Pasquali, Marianna Francesca Zanchi, Lucia Savasi, Valeria Spinillo, Arsenio Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up |
title | Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up |
title_full | Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up |
title_fullStr | Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up |
title_full_unstemmed | Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up |
title_short | Risk Analysis Stratification of CIN 2+ Development in a Cohort of Women Living with HIV with Negative Pap Smear and HR-HPV Test during a Long-Term Follow-Up |
title_sort | risk analysis stratification of cin 2+ development in a cohort of women living with hiv with negative pap smear and hr-hpv test during a long-term follow-up |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961029/ https://www.ncbi.nlm.nih.gov/pubmed/36851143 http://dx.doi.org/10.3390/vaccines11020265 |
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