@article{1066,
  author = {Cynthia Firnhaber and Hoa Van Le and Audrey Pettifor and Doreen Schulze and Pam Michelow and Ian Sanne and David Lewis and Anna-Lise Williamson and Bruce Allan and Sophia Williams and Allen Rinas and Simon Levin and Jennifer Smith},
  title = {Association between cervical dysplasia and human papillomavirus in HIV seropositive women from Johannesburg South Africa.},
  abstract = {<p><strong>OBJECTIVE: </strong>To examine the association between CD4 counts, HPV infection and the risk of cervical neoplasia among HIV-seropositive women.</p><p><strong>METHODS: </strong>A cross-sectional observational study was conducted among 1,010 HIV-seropositive women using cytology-based Pap smears. HPV DNA testing using Linear Array genotyping assay (Roche) was carried out in a subset of 191 patients. Multivariable-adjusted prevalence ratios (mPR) and 95\% confidence intervals (CIs) were estimated with log-binomial regression.</p><p><strong>RESULTS: </strong>Among 1,010 HIV-seropositive women, the prevalence of AGC/ASCUS, LSIL and HSIL or greater was 8.3, 23.5 and 18.0\%, respectively. The risk of cervical lesions was higher with CD4 \&lt; 200 cells/mm(3) vs. CD4 levels \&gt; 500/mm(3). HPV types 16 (41.7\%) and HPV 56 (22.2\%) were the most common types in HSIL cases. Women with CD4 levels \&lt; 200/mm(3) had a higher prevalence of HPV types 16 (p \&lt; 0.01) and 66 (p = 0.04). No statistical relationship between cervical lesions and HAART use was found.</p><p><strong>CONCLUSION: </strong>The burden of HPV infection and HSIL was high and correlated with HIV-induced immunosuppression. HPV 16 was the most common type in HSIL and increased in prevalence with greater immune suppression. Prophylactic HPV 16 vaccination could prevent approximately 40\% of HSIL cases. Strengthening screening programs is imperative in this population.</p>},
  year = {2010},
  journal = {Cancer causes \& control : CCC},
  volume = {21},
  pages = {433-43},
  month = {03/2010},
  issn = {1573-7225},
  doi = {10.1007/s10552-009-9475-z},
  language = {eng},
}