scholarly journals Vaginal microbiota diversity and paucity of Lactobacillus species are associated with persistent hrHPV infection in HIV negative but not in HIV positive women

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Eileen O. Dareng ◽  
Bing Ma ◽  
Sally N. Adebamowo ◽  
Ayotunde Famooto ◽  
Jacques Ravel ◽  
...  
Keyword(s):  
Estimating Equation ◽  
Vaginal Microbiota ◽  
Lactobacillus Species ◽  
Hiv Positive ◽  
Linear Discriminant ◽  
Hiv Positive Women ◽  
The Relationship ◽  
High Diversity ◽  
Hiv Negative

Abstract The vaginal microbiota is thought to play a role in modulating risk of high-risk human papillomavirus (hrHPV) infection. We examined the relationship between the vaginal microbiota and persistent hrHPV infection in HIV-negative and HIV-positive women. We used 16S-rRNA sequencing to characterize the vaginal microbiota of two serial samples taken six months apart from 211 Nigerian women (67%, 142/211 HIV-positive and 33%, 69/211 HIV-negative) and evaluated the association between the vaginal microbiota and persistent hrHPV infection using generalized estimating equation logistic regression models and linear discriminant analysis effect size (LEfSe) algorithm to identify phylotypic biomarkers of persistent hrHPV infection. The high diversity microbiota, Community State Type IV-B, was the most prevalent in both HIV-negative (38% at baseline, 30% at the follow-up visit) and HIV-positive (27% at baseline, 35% at the follow-up visit) women. The relationship between the vaginal microbiota and persistent hrHPV was modified by HIV status. In HIV-negative women, women with Lactobacillus dominant microbiota had lower odds (OR: 0.35, 95% CI 0.14–0.89, p = 0.03) of persistent hrHPV compared to women with Lactobacillus deficient microbiota. While among HIV-positive women, the odds of being persistently infected with hrHPV was higher in women with Lactobacillus dominant microbiota (OR: 1.25, 95% CI 0.73–2.14 p = 0.41). This difference in effect estimates by HIV was statistically significant (p = 0.02). A high diversity vaginal microbial community with paucity of Lactobacillus species was associated with persistent hrHPV infection in HIV-negative women but not in HIV-positive women.

scholarly journals A prospective study of demographic features and quality of life in HIV-positive women with cervical cancer treated at Tygerberg Hospital

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
George Du Toit ◽  
Martin Kidd
Keyword(s):  
Quality Of Life ◽  
Cervical Cancer ◽  
Cancer Treatment ◽  
Hiv Positive ◽  
Hiv Positive Women ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
Hiv Negative

Background: Cervical cancer and human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS) both have a high incidence in South Africa. Cervical cancer treatment of HIV-positive women poses challenges. Treatment-related changes in quality of life (QOL) of such women are important to future treatment protocols.Aim: To examine demographic data of HIV-negative and HIV-positive women at diagnosis of cervical cancer and describe their changes in QOL as a result of treatment.Methods and materials: All newly diagnosed patients with cervical cancer at Tygerberg Hospital were approached to participate in the study. The European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) and the Cervix Cancer Module (QLQ-CX24) were used. General QOL was measured with the EORTC QLQ-C30 and cervical-specific QOL with the QLQ-CX24 questionnaire. The patients completed the questionnaire at diagnosis, on completion of treatment and at 3 months’ follow-up.Results: The study included a total of 221 women of whom 22% were HIV-positive; the latter were younger and of higher educational level than the rest. Mean monthly income and stage distribution was similar between the two groups. HIV-positive patients underwent radiation therapy more commonly than chemoradiation. HIV-positive women showed statistically significantly higher loss to follow-up during the study. HIV-positive women experienced no improvement in insomnia, appetite loss, nausea, vomiting, diarrhoea, social role or any of the sexual domains. In contrast, HIV-negative women experienced statistically significant improvement in all sexual domains other than sexual/vaginal functioning. The QOL improvement of HIV-negative women was statistically significantly greater than their HIV-positive counterparts in the majority of QOL domains. Global health improved in both groups, with HIV-negative women experiencing greater improvement. HIV-positive women experienced an initial decline of peripheral neuropathy (PN) symptoms post treatment with a return to pretreatment values at 3 months’ follow-up. The change in PN was statistically significant between the HIV-negative and HIV-positive women.Conclusion: Demographic differences exist between the HIV-negative and HIV-positive groups. The differential outcome in the QOL of HIV-positive and HIV-negative women treated for cervical cancer might be related to persistence of AIDS-related symptoms on completion of cervical cancer treatment.

scholarly journals Recurrence of cervical intraepithelial neoplasia grades 2 or 3 in HIV-infected women treated by large loop excision of the transformation zone (LLETZ)

2008 ◽  
Vol 126 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Fábio Russomano ◽  
Aldo Reis ◽  
Maria José Camargo ◽  
Beatriz Grinsztejn ◽  
Maria Aparecida Tristão
Keyword(s):  
Cervical Intraepithelial Neoplasia ◽  
Highly Active Antiretroviral Therapy ◽  
Intraepithelial Neoplasia ◽  
Hiv Positive ◽  
Hiv Patients ◽  
Transformation Zone ◽  
Large Loop ◽  
Hiv Positive Women ◽  
Hiv Negative

CONTEXT AND OBJECTIVE: Women infected by HIV are more likely to have cervical cancer and its precursors. Treatment of the precursor lesions can prevent this neoplasia. The aim of this study was to assess the likelihood of recurrent cervical intraepithelial neoplasia grades 2 or 3 (CIN 2-3) in HIV-infected women, compared with HIV-negative women, all treated by large loop excision of the transformation zone (LLETZ). DESIGN AND SETTING: A cohort study in Instituto Fernandes Figueira, Fundação Oswaldo Cruz (IFF-Fiocruz), Rio de Janeiro. METHOD: 55 HIV-positive and 212 HIV-negative women were followed up after LLETZ for CIN 2-3 (range: 6-133 months). RESULTS: The incidence of recurrent CIN 2-3 was 30.06/10,000 woman-months in the HIV-positive group and 4.88/10,000 woman-months in the HIV-negative group (relative risk, RR = 6.16; 95% confidence interval, CI: 2.07-18.34). The likelihood of recurrence reached 26% at the 62nd month of follow-up among the HIV-positive women, and remained stable at almost 0.6% at the 93rd month of follow-up among the HIV-negative women. We were unable to demonstrate other prognostic factors relating to CIN recurrence, but the use of highly active antiretroviral therapy (HAART) may decrease the risk of this occurrence among HIV patients. CONCLUSION: After LLETZ there is a higher risk of recurrence of CIN 2-3 among HIV-positive women than among HIV-negative women. This higher risk was not influenced by margin status or grade of cervical disease treated. The use of HAART may decrease the risk of this occurrence in HIV patients.

Incidence of Cytological Abnormalities in Pap's Smear in HIV Positive Women

2018 ◽  
Vol 2 (S1) ◽  
pp. e000136
Author(s):  
Suhana Jotva ◽  
Hemani Desai ◽  
Hansa Goswami
Keyword(s):  
Trichomonas Vaginalis ◽  
Clinical History ◽  
Hiv Positive ◽  
Squamous Intraepithelial Lesions ◽  
Squamous Cells ◽  
Medical College ◽  
Hiv Positive Women ◽  
Cytological Abnormalities ◽  
Intraepithelial Lesions ◽  
Hiv Negative

Aims and Objectives: The aim of present study is to estimate the frequency of abnormal PAP’s smears and mainly to detect precancerous and cancerous lesions as well as inflammatory lesions in HIV infected women. Methodology: Our study was a retrospective study of total 130 cases and PAP’s smears were examined in cytology section in Department of Pathology, BJ Medical College, Ahmedabad from 1st March 2017 to 31st August 2017. Both HIV positive and HIV negative patients were included in the study. 80 patients were HIV negative and 50 patients were HIV positive. The clinical history and relevant parameters were noted. All the smears were processed by a conventional method using Papanicolaou stain.  Results: Out of 130 cases, 118 cases were reported negative for intraepithelial lesions or malignancy (NILM). Five cases were positive for squamous intraepithelial lesions (SIL) out of which four were HIV positive. Seven cases were of atypical squamous cells of undetermined significance (ASCUS) out of which 5 were HIV positive. Three cases were showing bacterial vaginosis. 1 case was showing Trichomonas Vaginalis. 19 cases were showing changes of non-specific inflammation. 6 cases were showing atrophic changes.  Conclusion: HIV infected women are at more risk to develop cervical cytological abnormalities. The study revealed a maximum number of non-specific inflammatory smears followed by smears showing atrophic changes. Smears suspicious for malignancy (ASCUS) and smears showing squamous intraepithelial lesions (SIL) were more common in HIV positive patients. Thus regular PAP’s smears screening as recommended by National AIDS Control Organization (NACO) will help in early detection of cervical abnormalities in HIV positive women. 

Food Insecurity Partially Mediates the Association Between Drug Use and Depressive Symptoms among Men who have Sex with Men in Los Angeles, California

2021 ◽  
pp. 1-26
Author(s):  
David A. Wiss ◽  
Marjan Javanbakht ◽  
Michael J. Li ◽  
Michael Prelip ◽  
Robert Bolan ◽  
...  
Keyword(s):  
Food Security ◽  
Depressive Symptoms ◽  
High Risk ◽  
Los Angeles ◽  
Drug Use ◽  
Food Insecurity ◽  
Hiv Positive ◽  
Sex With Men ◽  
The Relationship ◽  
Hiv Negative

Abstract Objective: To understand the relationship between drug use, food insecurity (FI), and mental health among men who have sex with men (MSM). Design: Cohort study (2014-2019) with at least one follow-up. Setting: Visits at 6-month intervals included self-assessment for FI and depressive symptoms. Urine testing results confirmed drug use. Factors associated with FI were assessed using multiple logistic regression with random effects for repeated measures. General structural equation modeling tested whether FI mediates the relationship between drug use and depressive symptoms. Participants: Data were from HIV-positive and high-risk HIV negative MSM in Los Angeles, CA (n=431; 1,192 visits). Results: At baseline, FI was reported by 50.8% of participants, depressive symptoms in 36.7%, and 52.7% of urine screening tests were positive for drugs (i.e., marijuana, opioids, methamphetamine, cocaine, ecstasy). A positive drug test was associated with a 96% increase in the odds of being food insecure (95% CI: 1.26-3.07). Compared to those with high food security, individuals with very low food security have a nearly 7-fold increase in the odds of reporting depressive symptoms (95% CI: 3.71-11.92). Findings showed 14.9% of the association between drug use (exposure) and depressive symptoms (outcome) can be explained by FI (mediator). Conclusion: The prevalence of FI among this cohort of HIV-positive and high-risk HIV-negative MSM was high; the association between drug use and depressive symptoms was partially mediated by FI. Findings suggest that enhancing access to food and nutrition may improve mood in the context of drug use, especially among MSM at risk for HIV-transmission.

scholarly journals Relationship between episodes of unsustained VTs detected early after an ICD implant and subsequent monomorphic VTs causing appropriate therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Jimenez-Candil ◽  
J Perez ◽  
M Sanchez ◽  
J Hernandez ◽  
J.L Morinigo ◽  
...  
Keyword(s):  
Estimating Equation ◽  
Left Ventricular ◽  
Adjusted Risk ◽  
Bland Altman Method ◽  
Appropriate Therapy ◽  
The Difference ◽  
Mean Cycle ◽  
Ventricular Tachycardias ◽  
The Relationship

Abstract Introduction Non-sustained ventricular tachycardias (NSVT) are observed frequently among ICD patients with left ventricular dysfunction (LVD). Purpose To analyze the relationship between episodes of NSVTs and monomorphic VTs (MVTs) that subsequently cause appropriate therapies. Methods 416 ICD patients with LVD (LVEF <45%) followed for 41±27 months. ICD programming (detection and therapies) was standardized. NSVT was defined as any VT of ≥5 beats which did not met the detection criteria occurring within the first 6 months after ICD implant. We analyzed 2201 NSVTs (10+7 beats), which occurred in 250 of the 416 patients (Median=2; IQR=0–7). The mean cycle length (CL) of NSVT was 323±32 ms (adjusted per multiple episodes/patient, generalized estimating equation method (GEEM)). Results During the follow-up, 1441 MVT occurred in 183 patients. After showing a significant correlation between burden of NSVT and the occurrence of appropriate therapies due to MVT (C coefficient=0.68; p<0.001), we observed that subjects with >5 NSVT presented an excess of adjusted risk: HR=1.97 (95% CI=1.45–2.72); p<0.001. However, the adjusted mean CL of NSVTs was similar in patients with (322±34) vs. without MVT (324±26 ms); p=0.3. Among patients who presented NSVTs and MVTs (n=145 subjects), we analyzed the relationship between the adjusted mean CL of the NSVTs (n=1288 episodes) and the CL of the first appropriate therapy due to MVT occurring subsequently. We found a significant and positive correlation between the two (r=0.88; p<0.001); the strongest correlation was observed in subjects with >5 NSVTs (r=0.97, n=52)). The robustness of such correlation was similar in individuals with ischemic (r=0.86; n=91) versus non-ischemic cardiomyopathy (r=0.90; n=54), and in primary (r=0.86; n=75) versus secondary prevention (r=0.90; n=70). The agreement between the CL of first MVT and the adjusted mean CL of NSVT episodes (GEEM) was determined according to the Bland-Altman Method. The difference between the two values was 2±8.3 ms, with only 7.6% (11/145) of patients in whom the difference between the two CL was outside the concordance limits. The agreement was greater, again, in individuals with >5 NSVTs. As shown in the Figure, in more than 95% of patients both values were within the interval of agreement (0.32±4 ms). Conclusions 1-The burden of NSVTs occurring early after an ICD implant, but not their CL, is associated with a higher incidence of appropriate therapies due to MVT at follow-up. 2-The CL of the NSVTs and that of the first and subsequent MVTs is virtually the same in patients with higher NSVT burden. Therefore, it could be the same tachycardia, but with different duration. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Persistent Low-Risk and High-Risk Human Papillomavirus Infections of the Uterine Cervix in HIV-Negative and HIV-Positive Women

2017 ◽  
Vol 5 ◽  
Author(s):  
Sally N. Adebamowo ◽  
Oluwatoyosi Olawande ◽  
Ayotunde Famooto ◽  
Eileen O. Dareng ◽  
Richard Offiong ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Uterine Cervix ◽  
Low Risk ◽  
Hiv Positive ◽  
Papillomavirus Infections ◽  
Hiv Positive Women ◽  
Hiv Negative

scholarly journals Prevalence, incidence, and distribution of human papillomavirus types in female sex workers in Kenya

2020 ◽  
Vol 31 (2) ◽  
pp. 109-118
Author(s):  
Kristen Sweet ◽  
Claire Bosire ◽  
Busola Sanusi ◽  
Carly J Sherrod ◽  
Jessie Kwatampora ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Female Sex ◽  
Hpv Prevalence ◽  
Hiv Negative

Female sex workers (FSWs) have a notably high risk of acquiring human papillomavirus (HPV) infections. Relatively few studies address the type-specific prevalence and incidence of HPV among FSWs in sub-Saharan Africa. FSWs (n = 348) attending the Korogocho clinic in Nairobi, Kenya participated from August 2009 to March 2011. HPV DNA was detected using the SPF10-LiPA25 PCR assay. Baseline prevalence of HPV infection and cervical dysplasia were calculated, stratified by HIV-serostatus. Incidence rate (IR) of infection was calculated as number of new infections from baseline over person-months among 160 HPV-negative participants with complete 12-month follow-up. Baseline HPV prevalence was 23.6% for any HPV and 20.4% for high-risk HPV (hrHPV) types. Most prevalent types were HPV52 (10.1%), HPV35 (2.3%), and HPV51 (2.3%). A quarter (24%) of participants were HIV-positive. HPV prevalence was higher in HIV-positive (32.1%) than HIV-negative (20.8%) participants. hrHPV prevalence was higher in HIV-positive (27.4%) than HIV-negative (18.2%) women. During follow-up, HPV IR was 31.4 (95% CI: 23.8–41.5) for any HPV and 24.2 (95% CI: 17.9–32.8) for hrHPV types. HPV52 had the highest IR (6.0; 95% CI: 6.5–10.3). Overall HPV and hrHPV prevalence were lower than expected, but both prevalence and incidence were higher in HIV-positive than in HIV-negative women.

scholarly journals Describing Point of Entry into Care and Being Lost to Program in a Cohort of HIV Positive Pregnant Women in a Large Urban Centre in Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Rachel Musomba ◽  
Frank Mubiru ◽  
Shadia Nakalema ◽  
Hope Mackline ◽  
Ivan Kalule ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Older Women ◽  
First Trimester ◽  
Hiv Positive ◽  
Urban Centre ◽  
Factors Associated ◽  
Point Of Entry ◽  
Art Initiation ◽  
Hiv Positive Women

Introduction. We aim to describe the time of entry into care and factors associated with being lost to program (LTP) in pregnant women on Option B Plus in an integrated HIV and antenatal care (ANC) clinic in Uganda. Methods. We included all pregnant women enrolled into the integrated HIV-ANC clinic from January 2012 to 31st July 2014, while the follow up period extended up to October 30th 2015. LTP was defined as being out of care for ≥3 months. Results. Overall 856 women were included. Only 36.4% (86/236) of the women were enrolled in the first trimester. Overall 69 (8.1%) were LTP. In the multivariate analysis older women (HR: 0.80 per five-year increase, CI: 0.64–1.0, and P=0.060) and women on ART at the time of pregnancy (0.58, CI: 0.34–0.98, and P=0.040) were more likely not to be LTP. Among women already on ART at the time of pregnancy no factor was associated with LTP. Conclusion. Our results suggest the need for interventions to enhance prompt linkage of HIV positive women to HIV services for ART initiation and for increased retention particularly in young and ART naive women.

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