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高效抗逆转录病毒疗法（HAART）及绝经对感染人类免疫缺陷病毒（HIV）的女性宫颈发育异常进展风险的影响。

Effect of highly active antiretroviral therapy (HAART) and menopause on risk of progression of cervical dysplasia in human immune-deficiency virus- (HIV-) infected women.

作者信息

Kim Suk Chul, Messing Susan, Shah Krupa, Luque Amneris E

机构信息

Division of Infectious Diseases, Department of Medicine, University of Rochester Medical Center, P.O. Box 689 601, Elmwood Avenue, Rochester, NY 14642, USA.

Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.

出版信息

Infect Dis Obstet Gynecol. 2013;2013:784718. doi: 10.1155/2013/784718. Epub 2013 Dec 18.

DOI:10.1155/2013/784718
PMID:24453469
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3878554/
Abstract

BACKGROUND

More HIV-infected women are reaching older age and menopause, but there is limited information on cervical squamous intraepithelial lesions (SILs) on these women.

METHODS

To assess the effect of HAART and menopause on SILs in HIV-infected women, we reviewed the results of Papanicolaou (Pap) tests obtained between 1991 and 2011 on 245 women. Progression to SILs was determined by comparing Pap test results. The association of HAART and transition to menopause on SILs was assessed using survival analysis.

RESULTS

Women receiving HAART had a 52% reduced risk in the progression to SILs compared to women receiving any other antiretroviral regimen or no regimen (CI: 0.33-0.70, P = 0.0001). A greater increase of CD4(+) cell counts was associated with a greater reduction on the risk of progression to SILs. Menopausal women had a 70% higher risk of progression to SILs than premenopausal women (CI: 1.11-2.62, P < 0.0001), adjusting for HIV medications, CD4(+) count, duration of HIV infection, moderation effect of menopause by age, prior IV drug use, and smoking.

CONCLUSION

HAART had a positive long-term effect on the progression to SILs. However, being younger and menopausal increases the risk of progression.

摘要

背景

越来越多感染HIV的女性步入老年并经历绝经，但关于这些女性宫颈鳞状上皮内病变（SILs）的信息有限。

方法

为评估高效抗逆转录病毒治疗（HAART）和绝经对感染HIV女性SILs的影响，我们回顾了1991年至2011年间245名女性的巴氏试验结果。通过比较巴氏试验结果确定SILs的进展情况。使用生存分析评估HAART和绝经转变对SILs的关联。

结果

与接受任何其他抗逆转录病毒治疗方案或未接受治疗方案的女性相比，接受HAART的女性进展为SILs的风险降低了52%（置信区间：0.33 - 0.70，P = 0.0001）。CD4(+)细胞计数的更大增加与进展为SILs风险的更大降低相关。在调整了HIV药物、CD4(+)计数、HIV感染持续时间、年龄对绝经的调节作用、既往静脉吸毒和吸烟情况后，绝经女性进展为SILs的风险比绝经前女性高70%（置信区间：1.11 - 2.62，P < 0.0001）。

结论

HAART对SILs的进展有积极的长期影响。然而，年轻和绝经会增加进展风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a55b/3878554/e417103ec840/IDOG2013-784718.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a55b/3878554/972d7c401c30/IDOG2013-784718.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a55b/3878554/e417103ec840/IDOG2013-784718.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a55b/3878554/972d7c401c30/IDOG2013-784718.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a55b/3878554/e417103ec840/IDOG2013-784718.002.jpg

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