首页 | 本学科首页   官方微博 | 高级检索  
     


Prevalence, Risk Factors, and Accuracy of Cytologic Screening for Cervical Intraepithelial Neoplasia in Women with the Human Immunodeficiency Virus
Authors:Mitchell Maiman M.D.  Rachel G. Fruchter Ph.D.  Alexander Sedlis M.D.  Joseph Feldman Dr.P.H.  Patrick Chen M.D.  Robert D. Burk M.D.  Howard Minkoff M.D.
Affiliation:aDepartment of Obstetrics and Gynecology, State University of New York–Health Science Center at Brooklyn, Brooklyn, New York, 11203;bDepartment of Preventive Medicine, State University of New York–Health Science Center at Brooklyn, Brooklyn, New York, 11203;cDepartment of Pathology, State University of New York–Health Science Center at Brooklyn, Brooklyn, New York, 11203;dDepartment of Pediatrics, Albert Einstein College of Medicine, New York, New York, 10461
Abstract:Objectives.The objective was to evaluate the sensitivity and specificity of cervical cytology in women infected with the human immunodeficiency virus (HIV), risk factors for abnormal cytology in HIV-infected and uninfected women, and risk factors for histologic diagnosis of cervical intraepithelial neoplasia (CIN) in HIV-infected women.Methods.Methods included a cross-sectional analysis of cervical cytology, colposcopic impression, and histology in 248 HIV-infected women and multivariate analyses of risk factors for abnormal cytology in 253 HIV-infected and 220 uninfected women and risk factors for CIN in 186 HIV-infected women.Results.The sensitivity and specificity of cytology for all CIN grades were 0.60 and 0.80 and, for high-grade CIN, 0.83 and 0.74. The prevalence of abnormal cytology was 32.9% in HIV-infected and 7.6% in HIV-negative women. Independent risk factors for abnormal cytology were immunodeficiency [odds ratio (OR) 8–17,P< 0.001] and human papillomavirus (HPV) infection (OR = 5,P< 0.001). The prevalence of CIN on histology was 32% in HIV-infected women, and the only independent risk factor for CIN was oncogenic HPV type (OR = 5,P= 0.005).Conclusion.Given the high prevalence of abnormal cytology and CIN in HIV-infected women, cytologic screening has significant limitations. Both immunodeficiency and type of HPV infection are important risk factors.
Keywords:
本文献已被 ScienceDirect 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号