High risk of human papillomavirus infection and cervical squamous intraepithelial lesions among women with symptomatic human immunodeficiency virus infection

Sten H. Vermund, Karen F. Kelley, Robert S. Klein, Anat R. Feingold, Klaus Schreiber, Gary Munk, Robert D. Burk

Research output: Contribution to journalArticle

238 Scopus citations

Abstract

We investigated the relationship of human papillomavirus (by cervicovaginal lavage and Southern blot), human immunodeficiency virus, and squamous intraepithelial lesions in 96 high-risk women in the Bronx, New York. Antibodies for human immunodeficiency virus were detected in 51 (53%) women. Of the 33 women with symptomatic human immunodeficiency virus infection, 23 (70%) had human papillomavirus infection compared with 4 of 18 (22%) asymptomatic women who were human immunodeficiency virus seropositive and 10 of 45 (22%) uninfected women (p < 0.0001). The rate of squamous intraepithelial lesions was 52% (14 of 27) for women with both viruses detected, 18% (6 of 34) for women with either virus detected, and 9% (3 of 35) for uninfected women. Among symptomatic human immunodeficiency virus-infected women, a strong association between human papillomavirus infection and squamous intraepithelial lesions was demonstrated (odds ratio, 12; 95% confidence interval, 1.3 to 108). Risk was highest for younger women from ethnic or racial minority groups. Advanced human immunodeficiency virus-related disease, with its associated immunosuppression, seems to exacerbate human papillomavirus-mediated cervical cytologic abnormalities. Public health measures are needed to provide Papanicolaou smear screening and appropriate clinical follow-up and treatment for women at high risk for human immunodeficiency virus infection.

Original languageEnglish (US)
Pages (from-to)392-400
Number of pages9
JournalAmerican Journal of Obstetrics and Gynecology
Volume165
Issue number2
DOIs
StatePublished - Aug 1991

Keywords

  • Human immunodeficiency virus
  • cervix
  • human papillomavirus
  • sexually transmitted diseases
  • squamous intraepithelial lesions

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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