Departamento de DST, AIDS e Hepatites virais, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brazil.
J Acquir Immune Defic Syndr. 2011 Aug;57 Suppl 3(Suppl 3):S212-6. doi: 10.1097/QAI.0b013e31821e996e.
Women living with HIV/AIDS present with a higher prevalence of human papillomavirus (HPV) infection, higher rates of squamous intraepithelial lesions, and are more susceptible to invasive cervical carcinoma progression.
We assessed the frequency of precursory cervical lesions of cancer and its risk factors for women living with HIV/AIDS.
Sociodemographic, clinical, behavioral, and laboratory data were collected from medical records from 2008 to 2009 and analyzed using forward stepwise logistic regression.
Medical records of 631 women were reviewed; mean age at AIDS diagnosis was 34 years old (interquartile range = 29-40 years old), 32% were <16 years old at first sexual intercourse; 61% had ≤5 sexual partners during life; 43% had been living with AIDS for ≥9 years; 47% reported previous sexually transmitted infections; 44% presented with HPV infection; and 10% presented with high squamous intraepithelial lesions. Presenting high squamous intraepithelial lesions was significantly associated with home district Human Development Index, age at AIDS diagnosis (>40 years old), time of AIDS diagnosis (>8 years), CD4 cell count <350/mm, and HPV infection.
Frequent squamous intraepithelial neoplasia in these women shows the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.
HIV/AIDS 感染者中 HPV 感染的发生率更高，宫颈上皮内瘤变的发生率更高，更易进展为浸润性宫颈癌。
评估 HIV/AIDS 感染者宫颈癌前病变的发生频率及其危险因素。
收集 2008 年至 2009 年的病历中的社会人口学、临床、行为和实验室数据，并采用逐步向前逻辑回归进行分析。
共回顾了 631 名妇女的病历；艾滋病诊断时的平均年龄为 34 岁（四分位距= 29-40 岁），32%的人首次性行为发生在 16 岁以下；61%的人一生中的性伴侣数≤5 个；43%的人感染艾滋病的时间≥9 年；47%的人报告有过性传播感染史；44%的人 HPV 感染；10%的人有高度宫颈上皮内瘤变。高度宫颈上皮内瘤变与家庭所在地区人类发展指数、艾滋病诊断时的年龄（>40 岁）、艾滋病诊断时间（>8 年）、CD4 细胞计数<350/mm 和 HPV 感染显著相关。
这些妇女中频繁出现的鳞状上皮内瘤变表明，在常规护理和对有宫颈病变的人进行随访时，进行妇科检查非常重要。
