TY - JOUR
T1 - Risk factors for squamous intraepithelial lesions on pap smear in women at risk for human immunodeficiency virus infection
AU - Klein, Robert S.
AU - Ho, Gloria Y.F.
AU - Vermund, Sten H.
AU - Fleming, Irene
AU - Burk, Robert D.
N1 - Funding Information:
Received 5 April) 994: revised 14 July 1994. Presented in part: annual meeting of the Infectious Diseases Society of America. October) 994. Orlando. Florida. Informed consent was obtained from all subjects, and the protocol was approved hy the institutional review hoard tor the protection of human subjects of Monrefiore Medical Center. Financial support: cooperative agreement with the Centers for Disease Control and Prevention (U64/CCU200714): National Institutes of Health (DA-04347): American Cancer Society (faculty award to R.D.B.). Reprints or correspondence: Dr. Robert S. Klein. AIDS Research Program. Montefiore Medical Center. I I I E. 2 lOth si., Bronx, NY 10467. * Present affiliation: Department of Epidemiology, University of Alabama School of Public Health. Birmingham.
PY - 1994/12
Y1 - 1994/12
N2 - To determine risk factors for squamous intraepitheliallesions (SIL) on Pap smear, 253 women at risk for human immunodeficiency virus (HIV) infection had Pap smear, HIV antibody testing, CD4+ cell measurements, and human papillomavirus (HPV) genome detection by Southern blot hybridization. Associated with SIL (P <.05) on univariate analysis were genital HPV (SIL prevalence in HPV-positive subjects, 36.3%; odds ratio [OR], 9.3; 95% confidence interval [CI], 4.2-20.3) and HIV infection (SIL prevalence in seropositive subjects, 21.9%; OR, 2.5; 95% Cl, 1.2-5.1). No demographic or behavioral variables were associated with risk for SIL. Multivariate analyses identified genital HPV infection (OR, 6.78; 95% Cl, 2.9-15.7), detection of known high-risk HPV types (OR, 11.8; 95% CI, 4.1-34.1), strong HPV Southern blot signal strength (OR, 10.8; 95% CI, 3.5-33.7), and severe HIV-related immunosuppression (OR, 3.1; 95% CI, 1.04-9.5) as independent risk factors associated with SIL. Thus, severe immunosuppression due to HIV infection increases the risk for SIL mediated by HPV infection.
AB - To determine risk factors for squamous intraepitheliallesions (SIL) on Pap smear, 253 women at risk for human immunodeficiency virus (HIV) infection had Pap smear, HIV antibody testing, CD4+ cell measurements, and human papillomavirus (HPV) genome detection by Southern blot hybridization. Associated with SIL (P <.05) on univariate analysis were genital HPV (SIL prevalence in HPV-positive subjects, 36.3%; odds ratio [OR], 9.3; 95% confidence interval [CI], 4.2-20.3) and HIV infection (SIL prevalence in seropositive subjects, 21.9%; OR, 2.5; 95% Cl, 1.2-5.1). No demographic or behavioral variables were associated with risk for SIL. Multivariate analyses identified genital HPV infection (OR, 6.78; 95% Cl, 2.9-15.7), detection of known high-risk HPV types (OR, 11.8; 95% CI, 4.1-34.1), strong HPV Southern blot signal strength (OR, 10.8; 95% CI, 3.5-33.7), and severe HIV-related immunosuppression (OR, 3.1; 95% CI, 1.04-9.5) as independent risk factors associated with SIL. Thus, severe immunosuppression due to HIV infection increases the risk for SIL mediated by HPV infection.
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U2 - 10.1093/infdis/170.6.1404
DO - 10.1093/infdis/170.6.1404
M3 - Article
C2 - 7995978
AN - SCOPUS:0028035157
SN - 0022-1899
VL - 170
SP - 1404
EP - 1409
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 6
ER -