Smith J R, Kitchen V S, Botcherby M, Hepburn M, Wells C, Gor D, Forster S M, Harris J R, Steer P, Mason P
Department of Obstetrics and Gynaecology, Charing Cross and Westminster Medical School, London, UK.
Br J Obstet Gynaecol. 1993 Feb;100(2):149-53. doi: 10.1111/j.1471-0528.1993.tb15211.x.
To test the hypotheses: (1) that HIV infection predisposes to cervical intraepithelial neoplasia (CIN); (2) that this CIN is a result of HIV related immunosuppression; and (3) that this CIN is a result of immunosuppression causing increased expression of the potentially oncogenic viruses, human papilloma virus (HPV), Epstein Barr virus (EBV) and herpes simplex virus (HSV).
A matched cross sectional study.
The Department of Gynaecological Oncology, The Samaritan Hospital, London; the Department of Genitourinary Medicine, St Mary's Hospital, London; and the Family Planning Clinic, Claremont Terrace, Glasgow.
Fifty HIV seropositive women enrolled from the Genitourinary Medicine Department and the Drug Dependency Unit at St Mary's Hospital, London, and the Unit of Infectious Diseases at Ruchill Hospital, Glasgow. Forty-three HIV seronegative controls enrolled from the Department of Genitourinary Medicine at St Mary's Hospital, matched against 43 of the seropositive women for age, age at first intercourse, lifetime number of sexual partners, and smoking habit.
Associations between CIN, as detected by cytology and histology, and HIV infection. Association was also sought between CIN and immunosuppression, as measured clinically by T4 cell number, beta-2-microglobulin and p24 antigen. Associations of these with: (1) HPV, as detected by Southern blot testing and the polymerase chain reaction; (2) EBV, as detected by Southern blot testing; and (3) HSV, as detected by tissue culture of endocervical swabs, was also studied.
There was no significant difference in the prevalence of CIN or oncogenic viruses between HIV seropositive and seronegative women in the absence of immunosuppression. If the HIV infected women showed signs of immunosuppression, the prevalence of CIN was increased. No association was shown between detection of HPV, EBV and HSV and immunosuppression or CIN.
HIV infection may only be associated with an increased risk of CIN when immunosuppression is present.
验证以下假设：（1）HIV感染易导致宫颈上皮内瘤变（CIN）；（2）这种CIN是HIV相关免疫抑制的结果；（3）这种CIN是免疫抑制导致潜在致癌病毒——人乳头瘤病毒（HPV）、爱泼斯坦-巴尔病毒（EBV）和单纯疱疹病毒（HSV）表达增加的结果。
配对横断面研究。
伦敦撒玛利亚医院妇科肿瘤科；伦敦圣玛丽医院泌尿生殖医学科；格拉斯哥克莱蒙特街计划生育诊所。
从伦敦圣玛丽医院泌尿生殖医学科和药物依赖科以及格拉斯哥鲁奇尔医院传染病科招募的50名HIV血清阳性女性。从圣玛丽医院泌尿生殖医学科招募的43名HIV血清阴性对照者，与43名血清阳性女性在年龄、初次性交年龄、性伴侣终生数量和吸烟习惯方面进行匹配。
通过细胞学和组织学检测的CIN与HIV感染之间的关联。还寻求CIN与免疫抑制之间的关联，免疫抑制通过T4细胞数量、β2-微球蛋白和p24抗原进行临床测量。研究这些指标与以下方面的关联：（1）通过Southern印迹检测和聚合酶链反应检测的HPV；（2）通过Southern印迹检测的EBV；（3）通过宫颈拭子组织培养检测的HSV。
在没有免疫抑制的情况下，HIV血清阳性和血清阴性女性之间CIN或致癌病毒的患病率没有显著差异。如果HIV感染女性出现免疫抑制迹象，CIN的患病率会增加。HPV、EBV和HSV的检测与免疫抑制或CIN之间未显示出关联。
只有在存在免疫抑制时，HIV感染才可能与CIN风险增加相关。
