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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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+.
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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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