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Natural History of Cervical Intraepithelial Neoplasia-2 in HIV-Positive Women of Reproductive Age.
- Source :
-
JAIDS: Journal of Acquired Immune Deficiency Syndromes . 12/15/2018, Vol. 79 Issue 5, p573-579. 7p. - Publication Year :
- 2018
-
Abstract
- Objective: To evaluate the natural history of treated and untreated cervical intraepithelial neoplasia-2 (CIN2) among HIV-positive women. Methods: Participants were women enrolled in the Women's Interagency HIV Study between 1994 and 2013. One hundred four HIV-positive women diagnosed with CIN2 before age 46 were selected, contributing 2076 visits over a median of 10 years (interquartile range 5-16). The outcome of interest was biopsy-confirmed CIN2 progression, defined as CIN3 or invasive cervical cancer. CIN2 treatment was abstracted from medical records. Results: Most women were African American (53%), current smokers (53%), and had a median age of 33 years at CIN2 diagnosis. Among the 104 HIV-positive women, 62 (59.6%) did not receive CIN2 treatment. Twelve HIV-positive women (11.5%) showed CIN2 progression to CIN3; none were diagnosed with cervical cancer. There was no difference in the median time to progression between CIN2-treated and CIN2-untreated HIV-positive women (2.9 vs. 2.7 years, P = 0.41). CIN2 treatment was not associated with CIN2 progression in multivariate analysis (adjusted hazard ratio 1.82; 95% confidence interval: 0.54 to 7.11), adjusting for combination antiretroviral therapy and CD4+ T-cell count. In HIV-positive women, each increase of 100 CD4+ T cells was associated with a 33% decrease in CIN2 progression (adjusted hazard ratio 0.67; 95% confidence interval: 0.47 to 0.88), adjusting for CIN2 treatment and combination antiretroviral therapy. Conclusions: CIN2 progression is uncommon in this population, regardless of CIN2 treatment. Additional studies are needed to identify factors to differentiate women at highest risk of CIN2 progression. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 15254135
- Volume :
- 79
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- JAIDS: Journal of Acquired Immune Deficiency Syndromes
- Publication Type :
- Academic Journal
- Accession number :
- 139727970
- Full Text :
- https://doi.org/10.1097/QAI.0000000000001865