Ceccato Junior Benito Pio Vitorio, Guimarães Mark Drew Crosland, Lopes Ana Paula Ceccato, Nascimento Lorena Fiorini, Novaes Luísa Magalhães, Del Castillo Dora Méndez, Melo Victor Hugo
Department of Gynecology and Obstetrics, Faculdade de Ciencias Médicas de Minas Gerais - FCCMG, Belo Horizonte, Minas Gerais, Brazil.
Department of Preventive and Social Medicine, Faculdade de Medicina, UFMG, Belo Horizonte, Minas Gerais, Brazil.
Rev Bras Ginecol Obstet. 2016 May;38(5):231-8. doi: 10.1055/s-0036-1583294. Epub 2016 Apr 28.
Objectives To evaluate the incidence and factors associated with cervical intraepithelial neoplasia (CIN) and cervical infection by human papillomavirus (HPV) among HIV-positive and HIV-negative women. Methods A cohort of 103 HIV positive and 113 HIV negative women were monitored between October 2008 and February 2012, for at least one year. Procedures included cervical cytology, DNA/HPV detection by polymerase chain reaction, colposcopy with biopsy if necessary, followed by an interview for exposure characteristics data. CIN was based on the histopathological results. Results The incidence of CIN was of 8.8 and 4.6 cases/100 women-years in HIV-positive and HIV-negative women, respectively. HIV-positive women presented a hazard ratio (HR) of 2.8 for CIN and developed lesions earlier (0.86 year) than HIV-negative women (2 years) (p = 0.01). The risk of developing CIN decreased with age (HR = 0.9) and marital status (HR = 0.4). HPV patients presented a higher incidence of CIN when compared HIV-positive and HIV-negative women (p = 0.01). The incidence of HPV cervical infection was 18.1 and 11.4 cases/100 women-years in HIV-positive and HIV-negative women, respectively. Those HIV-positive presented earlier HPV infection(p = 0.002). The risk of developing HPV infection decreased with age and was higher among HIV-positive women. HPV 16 was the most common type in HIV-positive women, and also the type most closely associated with CIN in HIV-negative women. Conclusions HIV-positive women had a greater incidence of HPV and CIN, and in a shorter time interval. More rigorous and timely clinical control is required for this group.
评估HIV阳性和HIV阴性女性中宫颈上皮内瘤变（CIN）的发病率及相关因素，以及人乳头瘤病毒（HPV）宫颈感染情况。方法：2008年10月至2012年2月期间，对103名HIV阳性女性和113名HIV阴性女性组成的队列进行了至少一年的监测。检查程序包括宫颈细胞学检查、通过聚合酶链反应进行DNA/HPV检测、必要时进行阴道镜检查及活检，随后进行访谈以获取暴露特征数据。CIN依据组织病理学结果确定。结果：HIV阳性和HIV阴性女性中CIN的发病率分别为8.8例/100女性年和4.6例/100女性年。HIV阳性女性发生CIN的风险比（HR）为2.8，且比HIV阴性女性更早出现病变（0.86年比2年）（p = 0.01）。发生CIN的风险随年龄（HR = 0.9）和婚姻状况（HR = 0.4）降低。与HIV阳性和HIV阴性女性相比，HPV感染患者CIN的发病率更高（p = 0.01）。HIV阳性和HIV阴性女性中HPV宫颈感染的发病率分别为18.1例/100女性年和11.4例/100女性年。HIV阳性女性HPV感染更早出现（p = 0.002）。发生HPV感染的风险随年龄降低，且在HIV阳性女性中更高。HPV 16是HIV阳性女性中最常见的类型，也是HIV阴性女性中与CIN关联最密切的类型。结论：HIV阳性女性HPV和CIN的发病率更高，且发病时间间隔更短。该群体需要更严格和及时的临床管控。
