坦桑尼亚达累斯萨拉姆HIV-1血清阳性女性宫颈鳞状上皮内病变的危险因素。

Risk factors for cervical squamous intraepithelial lesions among HIV-1 seropositive women in Dar es Salaam, Tanzania.

作者信息

Kapiga S H, Msamanga G I, Spiegelman D, Mwakyoma H, Fawzi W W, Hunter D J

机构信息

Department of Epidemiology and Biostatistics, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.

出版信息

Int J Gynaecol Obstet. 1999 Nov;67(2):87-94. doi: 10.1016/s0020-7292(99)00125-3.

DOI:10.1016/s0020-7292(99)00125-3

PMID:10636052

Abstract

OBJECTIVES

To determine the prevalence and risk factors for cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Dar es Salaam, Tanzania.

METHODS

Between July 1996 and December 1997 we interviewed 691 HIV-infected women to obtain information about risk factors for SIL. Cervical smears and samples for lymphocyte subsets and sexually transmitted diseases (STD) diagnosis were collected.

RESULTS

The prevalence of SIL was 2.9% (20/686) (95% CI = 1.7-4.2%). Eleven women had low-grade SIL while nine women had high-grade SIL. The number of lifetime sexual partners and live births was associated with a marginally non-significant increased risk of SIL. The risk of SIL was significantly increased among women with CD4+ cell count < 200/mm3 (multivariate odds ratio (OR) = 6.15, 95% CI = 1.19-41.37) and decreased by 68% for each 5-cm increase in mid-upper arm circumference (multivariate OR = 0.32, 95% CI = 0.10-0.93).

CONCLUSIONS

HIV-related immunosuppression and wasting and long-term sexual behavior were the major determinants of SIL in this population. Federation of Gynecology and Obstetrics.

摘要

目的

确定坦桑尼亚达累斯萨拉姆市感染艾滋病毒妇女的宫颈鳞状上皮内病变（SIL）患病率及危险因素。

方法

在1996年7月至1997年12月期间，我们对691名感染艾滋病毒的妇女进行了访谈，以获取有关SIL危险因素的信息。收集了宫颈涂片以及用于淋巴细胞亚群和性传播疾病（STD）诊断的样本。

结果

SIL的患病率为2.9%（20/686）（95%可信区间=1.7 - 4.2%）。11名妇女患有低度SIL，9名妇女患有高度SIL。终身性伴侣数量和活产次数与SIL风险略有增加但无统计学意义相关。CD4 +细胞计数<200/mm3的妇女中SIL风险显著增加（多变量优势比（OR）=6.15，95%可信区间=1.19 - 41.37），而上臂中部周长每增加5厘米，SIL风险降低68%（多变量OR =0.32，95%可信区间=0.10 - 0.93）。