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. 1999 Apr;75(2):103–106. doi: 10.1136/sti.75.2.103

Cervical dysplasia and HIV type 1 infection in African pregnant women: a cross sectional study, Kigali, Rwanda. The Pregnancy and HIV Study Group (EGE)

V Leroy, J Ladner, A De Clercq, A Meheus, M Nyiraziraje, E Karita, F Dabis
PMCID: PMC1758192  PMID: 10448362

Abstract

OBJECTIVE: To study the prevalence of cervical squamous intraepithelial lesions (SILs) and their association with HIV-1 infection and immunodeficiency among pregnant women in Kigali, Rwanda. METHODS: As part of a cohort study on the impact of HIV-1 infection on pregnancy outcome, HIV-1 seropositive (HIV+) and seronegative (HIV-) pregnant women were enrolled during the last trimester of pregnancy at the maternity ward of the Centre Hospitalier de Kigali from July 1992 to August 1993. At inclusion, women were screened for sexually transmitted diseases (STDs)--syphilis, Neisseria gonorrhoeae, chlamydia trachomatis, Trichomonas vaginalis. CD4+ lymphocyte counts were measured and a Papanicolaou smear performed. RESULTS: Papanicolaou smear was interpretable in 103 HIV+ women and 107 HIV- women. Prevalence of SILs was significantly higher in HIV+ women than in HIV- women: 24.3% v 6.5% (odds ratio = 4.6; 95% CI: 1.8-12.3). SIL+ women (n = 32) tended to have more STDs than SIL- women (n = 178), but this did not reach a statistical difference: 37.5% and 24.7% respectively (p = 0.13). They also had a mean CD4 count significantly lower than SIL- women (623 and 784 CD4+ cells x 10(6)/l, respectively; p = 0.02). CONCLUSION: SILs were HIV related and the association with immunosuppression was statistically significant. Prevalence of SILs was high in this population of pregnant women with high HIV/STDs prevalence. Screening policy for STDs and SILs in African women should be assessed in prenatal care. 






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Selected References

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  1. Chao A., Bulterys M., Musanganire F., Habimana P., Nawrocki P., Taylor E., Dushimimana A., Saah A. Risk factors associated with prevalent HIV-1 infection among pregnant women in Rwanda. National University of Rwanda-Johns Hopkins University AIDS Research Team. Int J Epidemiol. 1994 Apr;23(2):371–380. doi: 10.1093/ije/23.2.371. [DOI] [PubMed] [Google Scholar]
  2. Feingold A. R., Vermund S. H., Burk R. D., Kelley K. F., Schrager L. K., Schreiber K., Munk G., Friedland G. H., Klein R. S. Cervical cytologic abnormalities and papillomavirus in women infected with human immunodeficiency virus. J Acquir Immune Defic Syndr. 1990;3(9):896–903. [PubMed] [Google Scholar]
  3. Klein R. S., Ho G. Y., Vermund S. H., Fleming I., Burk R. D. Risk factors for squamous intraepithelial lesions on Pap smear in women at risk for human immunodeficiency virus infection. J Infect Dis. 1994 Dec;170(6):1404–1409. doi: 10.1093/infdis/170.6.1404. [DOI] [PubMed] [Google Scholar]
  4. Kreiss J. K., Kiviat N. B., Plummer F. A., Roberts P. L., Waiyaki P., Ngugi E., Holmes K. K. Human immunodeficiency virus, human papillomavirus, and cervical intraepithelial neoplasia in Nairobi prostitutes. Sex Transm Dis. 1992 Jan-Feb;19(1):54–59. doi: 10.1097/00007435-199201000-00011. [DOI] [PubMed] [Google Scholar]
  5. La Ruche G., You B., Mensah-Ado I., Bergeron C., Montcho C., Ramon R., Touré-Coulibaly K., Welffens-Ekra C., Dabis F., Orth G. Human papillomavirus and human immunodeficiency virus infections: relation with cervical dysplasia-neoplasia in African women. Int J Cancer. 1998 May 18;76(4):480–486. doi: 10.1002/(sici)1097-0215(19980518)76:4<480::aid-ijc6>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  6. Laga M., Icenogle J. P., Marsella R., Manoka A. T., Nzila N., Ryder R. W., Vermund S. H., Heyward W. L., Nelson A., Reeves W. C. Genital papillomavirus infection and cervical dysplasia--opportunistic complications of HIV infection. Int J Cancer. 1992 Jan 2;50(1):45–48. doi: 10.1002/ijc.2910500110. [DOI] [PubMed] [Google Scholar]
  7. Langley C. L., Benga-De E., Critchlow C. W., Ndoye I., Mbengue-Ly M. D., Kuypers J., Woto-Gaye G., Mboup S., Bergeron C., Holmes K. K. HIV-1, HIV-2, human papillomavirus infection and cervical neoplasia in high-risk African women. AIDS. 1996 Apr;10(4):413–417. doi: 10.1097/00002030-199604000-00010. [DOI] [PubMed] [Google Scholar]
  8. Leroy V., De Clercq A., Ladner J., Bogaerts J., Van de Perre P., Dabis F. Should screening of genital infections be part of antenatal care in areas of high HIV prevalence? A prospective cohort study from Kigali, Rwanda, 1992-1993. The Pregnancy and HIV (EGE) Group. Genitourin Med. 1995 Aug;71(4):207–211. doi: 10.1136/sti.71.4.207. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Leroy V., Ladner J., Nyiraziraje M., De Clercq A., Bazubagira A., Van de Perre P., Karita E., Dabis F. Effect of HIV-1 infection on pregnancy outcome in women in Kigali, Rwanda, 1992-1994. Pregnancy and HIV Study Group. AIDS. 1998 Apr 16;12(6):643–650. doi: 10.1097/00002030-199806000-00014. [DOI] [PubMed] [Google Scholar]
  10. Maggwa B. N., Hunter D. J., Mbugua S., Tukei P., Mati J. K. The relationship between HIV infection and cervical intraepithelial neoplasia among women attending two family planning clinics in Nairobi, Kenya. AIDS. 1993 May;7(5):733–738. doi: 10.1097/00002030-199305000-00019. [DOI] [PubMed] [Google Scholar]
  11. Motti P. G., Dallabetta G. A., Daniel R. W., Canner J. K., Chiphangwi J. D., Liomba G. N., Yang L., Shah K. V. Cervical abnormalities, human papillomavirus, and human immunodeficiency virus infections in women in Malawi. J Infect Dis. 1996 Mar;173(3):714–717. doi: 10.1093/infdis/173.3.714. [DOI] [PubMed] [Google Scholar]
  12. Parkin D. M., Stjernswärd J., Muir C. S. Estimates of the worldwide frequency of twelve major cancers. Bull World Health Organ. 1984;62(2):163–182. [PMC free article] [PubMed] [Google Scholar]
  13. Schulz T. F., Boshoff C. H., Weiss R. A. HIV infection and neoplasia. Lancet. 1996 Aug 31;348(9027):587–591. doi: 10.1016/S0140-6736(95)11033-X. [DOI] [PubMed] [Google Scholar]
  14. Seck A. C., Faye M. A., Critchlow C. W., Mbaye A. D., Kuypers J., Woto-Gaye G., Langley C., De E. B., Holmes K. K., Kiviat N. B. Cervical intraepithelial neoplasia and human papillomavirus infection among Senegalese women seropositive for HIV-1 or HIV-2 or seronegative for HIV. Int J STD AIDS. 1994 May-Jun;5(3):189–193. doi: 10.1177/095646249400500307. [DOI] [PubMed] [Google Scholar]
  15. Vernon S. D., Holmes K. K., Reeves W. C. Human papillomavirus infection and associated disease in persons infected with human immunodeficiency virus. Clin Infect Dis. 1995 Aug;21 (Suppl 1):S121–S124. doi: 10.1093/clinids/21.supplement_1.s121. [DOI] [PubMed] [Google Scholar]

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