Gessesse Zekariase, Tadesse Zemen, Alemayehu Mussie, Hiruye Abiy, Getachew Yeneneh, Derbew Miliard, Mariam Damen Haile, Mammo Dereje, Eva Kantelhardt, Yebyo Henock, Michael Hailay Gebre
Ethiop Med J. 2015 Jul;Suppl 2:17-24.
Cervical cancer is the second commonest type and third cause of cancer death among women in low-income countries. Women living with HIV/AIDS are at greater risk of developing cervical cancer. The study aimed to identify the determinant factors forsuspected precancerous cervical lesions among HIV- positive women in Mekelle hospital, Ethiopia.
Anunmatched case-control study was conducted among randomly selected HIV positive women in Mekelle hospital in 2014. In Mekelle Hospital, routine screening for lesions of the cervix uteri by visual inspection with acetic acid (VIA) is done in HIV positive women by trained nurses. Suspicious findings are treated by cryotherapy or referred to the Gynaecologist. A number of 116 cases, who had suspicious findings on VIA, and 232 HIV-positive controls without suspicious findings on VIA were randomly selected and enrolled into the study The determinant factors for precancerous cervical lesion were analyzed using multiple logistic regression and described as adjusted odds ratio (AOR).
HIV positive women who had CD4 cells less than 350/mm3 were two times more likely to have precancerous cervical lesion compared to those with CD4 cells above 350/mm3. Women with two (AOR = 3.6; 95% CI: 1.7, 7.7) and three (AOR = 2.5; 95% CI: 1.2, 5.4) sexual partners were four and three times more likely to have precancerous cervical lesion, respectively, as compared to those who had one sexual partner. Age, History of STI and duration of ART had no influence on presence of VIA positive lesions in HIV positive women.
CD4 count cells and number of sexual partners were predictors of VIA positive cervical lesion among HIV positive women.
宫颈癌是低收入国家女性中第二常见的癌症类型,也是癌症死亡的第三大原因。感染艾滋病毒/艾滋病的女性患宫颈癌的风险更高。本研究旨在确定埃塞俄比亚默克莱医院艾滋病毒阳性女性中疑似宫颈癌前病变的决定因素。
2014年在默克莱医院对随机选取的艾滋病毒阳性女性进行了一项非匹配病例对照研究。在默克莱医院,由经过培训的护士对艾滋病毒阳性女性进行醋酸目视检查(VIA)以常规筛查子宫颈病变。可疑结果采用冷冻疗法治疗或转诊给妇科医生。随机选取116例VIA检查有可疑结果的病例和232例VIA检查无可疑结果的艾滋病毒阳性对照纳入研究。使用多元逻辑回归分析宫颈癌前病变的决定因素,并将其描述为调整优势比(AOR)。
与CD4细胞高于350/mm³的艾滋病毒阳性女性相比,CD4细胞低于350/mm³的艾滋病毒阳性女性患宫颈癌前病变的可能性高出两倍。有两个(AOR = 3.6;95% CI:1.7,7.7)和三个(AOR = 2.5;95% CI:1.2,5.4)性伴侣的女性患宫颈癌前病变的可能性分别是只有一个性伴侣的女性的四倍和三倍。年龄、性传播感染史和抗逆转录病毒治疗持续时间对艾滋病毒阳性女性VIA阳性病变的存在没有影响。
CD4细胞计数和性伴侣数量是艾滋病毒阳性女性VIA阳性宫颈病变的预测因素。