Maggwa B N, Hunter D J, Mbugua S, Tukei P, Mati J K
Department of Obstetrics and Gynecology, University of Nairobi, Kenya.
AIDS. 1993 May;7(5):733-8. doi: 10.1097/00002030-199305000-00019.
To determine the relationship between HIV-1 infection and cervical intraepithelial neoplasia (IN) among women at relatively low risk for both conditions.
A case-control study comparing women with cytological evidence of IN (cases) with those without IN (controls) and HIV-1 serostatus as the principal exposure of interest.
A total of 4058 women attending two family planning clinics in Nairobi, Kenya between October 1989 and May 1991 were enrolled following HIV pretest counseling and informed consent. Structured interviews by trained nurses and medical students were used to obtain data on social, demographic, contraceptive practice and sexual behavior variables. A Papanicolaou smear specimen for cervical cytology and an endocervical swab for gonorrhea culture were obtained. HIV-1 serostatus was determined by enzyme-linked immunosorbent assay and confirmed by Western blot; syphilis serostatus was determined by the rapid plasma reagin test.
Eighty-two of the 4058 (2.02%) women had cytological evidence of IN. We observed a significant positive association between HIV-1 infection and IN that remained after controlling for sexual behavior, contraceptive practices and other potential confounding variables (odds ratio, 2.78; 95% confidence interval 1.32-5.85). clinical symptoms and signs were uncommon among the HIV-1-seropositive women, suggesting that they were still in the early stages of the infection.
The risk of IN among women even in the early stages of HIV-1 infection is increased.
确定在两种情况风险相对较低的女性中，HIV-1感染与宫颈上皮内瘤变（IN）之间的关系。
一项病例对照研究，比较有IN细胞学证据的女性（病例组）和无IN的女性（对照组），并将HIV-1血清学状态作为主要研究的暴露因素。
1989年10月至1991年5月期间，在肯尼亚内罗毕的两家计划生育诊所就诊的4058名女性在接受HIV检测前咨询并获得知情同意后被纳入研究。由训练有素的护士和医学生进行结构化访谈，以获取有关社会、人口统计学、避孕措施和性行为变量的数据。采集用于宫颈细胞学检查的巴氏涂片标本和用于淋病培养的宫颈拭子。通过酶联免疫吸附测定法确定HIV-1血清学状态，并通过蛋白质印迹法进行确认；通过快速血浆反应素试验确定梅毒血清学状态。
4058名女性中有82名（2.02%）有IN细胞学证据。我们观察到HIV-1感染与IN之间存在显著正相关，在控制性行为、避孕措施和其他潜在混杂变量后该相关性仍然存在（比值比，2.78；95%置信区间1.32 - 5.85）。HIV-1血清学阳性的女性中临床症状和体征并不常见，这表明她们仍处于感染的早期阶段。
即使在HIV-1感染的早期阶段，女性发生IN的风险也会增加。
