Abstract
Objective. The aim of this study was to determine the high
risk human papillomavirus (HR-
HPV) prevalence and specific risk factors for abnormal Papanicolaou
(Pap) smear in a human
immunodeficiency virus (HIV) infected population. Additionally, the
utility of HPV viral load
using relative light unit (RLU) readings in predicting cervical
disease was assessed.
Methods. This is a cross-sectional study with 569
HIV-infected women who were enrolled from
six different cities across the United States. Risk factor analysis
was performed using
multivariate logistic regression.
Findings. A total of 486 HIV-infected women were included in
this analysis. HR-HPV was
found in 45% of the population with 25% having an infection with
type 16 or 18. For the group
as a whole, history of an abnormal Pap smear, CD4 count <200,
history of antiretroviral use,
presence of HR-HPV regardless of RLU cut-off, and presence of low
risk HPV (LR-HPV) were
found to be risk factors for an abnormal Pap smear. On subgroup
analysis of those co-infected
with HR-HPV and HIV, history of antiretroviral use, RLU ≥ 20,
CD4 count < 200, history of an
abnormal Pap smear, and infection with more than one HR-HPV type
were found to be risk
factors for an abnormal Pap smear. Finally, a strong association
between having an abnormal Pap
smear and presence of HR-HPV with an RLU ≥ 20 (RR=55.2) was
found.
Conclusions: This study was able to identify important
predictors of having an abnormal Pap
smear in HIV-infected women which may help to individualize
follow-up and treatment. HPV
viral load as measured by RLU was found to be predictive of
cervical disease which could prove
useful in resource poor areas where further testing is not readily
available. Finally, only 25% of
those infected with HR-HPV were infected with either 16 or 18. This
implies that in HIV-
infected women the vaccine subtypes may need to be broadened.
Table of Contents
Table of Contents
I. Introduction
II. Background
III. Methods
IV. Results
V. Discussion
VI. References
VII. Tables
About this Dissertation
Rights statement
- Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
| School |
|
|---|
| Department |
|
|---|
| Degree |
|
|---|
| Submission |
|
|---|
| Language |
|
|---|
| Research Field |
|
|---|
| 关键词 |
|
|---|
| Committee Chair / Thesis Advisor |
|
|---|
| Committee Members |
|
|---|