Impact of HIV infection on invasive cervical cancer in Kenyan women

The bulk of the human immunodeficiency virus (HIV) pandemic continues to ravage the developing world, especially sub-Saharan countries. The HIV seroprevalence among women with invasive cervical cancer varies in different parts of the world. A comparison of women with cervical cancer was undertaken for epidemiologic data in the province of KwaZulu-Natal, South Africa, which has the highest HIV prevalence. The two time periods of study were 1999 and 2003. The aim was to determine the trends of prevalence of invasive cervical cancer and HIV infection among such women. While the background prevalence of HIV infection among women with invasive cervical cancer in our setting has remained constant over the two time periods (21% and 21.8%), there has been a significant reduction in the number of women presenting with invasive cervical cancer to our center (672 to 271) over the two time periods, with no changes in other variables. On the contrary, the prevalence of HIV infection among antenatal attendees had risen from 32.5% to 38.5% in the 1999 and 2003 periods, respectively. Reasons for this dramatic trend are presented together with other epidemiologic data.

Download Full-text

HIV Infection and Survival Among Women With Cervical Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2016.67.9613 ◽

2016 ◽

Vol 34 (31) ◽

pp. 3749-3757 ◽

Cited By ~ 49

Author(s):

Scott Dryden-Peterson ◽

Memory Bvochora-Nsingo ◽

Gita Suneja ◽

Jason A. Efstathiou ◽

Surbhi Grover ◽

...

Keyword(s):

Cervical Cancer ◽

Hiv Infection ◽

Cell Count ◽

Invasive Cervical Cancer ◽

Hazard Ratio ◽

External Beam Radiation ◽

Beam Radiation ◽

Cd4 Cell Count ◽

Women With Hiv ◽

Cd4 Cell

Purpose Cervical cancer is the leading cause of cancer death among the 20 million women with HIV worldwide. We sought to determine whether HIV infection affected survival in women with invasive cervical cancer. Patients and Methods We enrolled sequential patients with cervical cancer in Botswana from 2010 to 2015. Standard treatment included external beam radiation and brachytherapy with concurrent cisplatin chemotherapy. The effect of HIV on survival was estimated by using an inverse probability weighted marginal Cox model. Results A total of 348 women with cervical cancer were enrolled, including 231 (66.4%) with HIV and 96 (27.6%) without HIV. The majority (189 [81.8%]) of women with HIV received antiretroviral therapy before cancer diagnosis. The median CD4 cell count for women with HIV was 397 (interquartile range, 264 to 555). After a median follow-up of 19.7 months, 117 (50.7%) women with HIV and 40 (41.7%) without HIV died. One death was attributed to HIV and the remaining to cancer. Three-year survival for the women with HIV was 35% (95% CI, 27% to 44%) and 48% (95% CI, 35% to 60%) for those without HIV. In an adjusted analysis, HIV infection significantly increased the risk for death among all women (hazard ratio, 1.95; 95% CI, 1.20 to 3.17) and in the subset that received guideline-concordant curative treatment (hazard ratio, 2.63; 95% CI, 1.05 to 6.55). The adverse effect of HIV on survival was greater for women with a more-limited stage cancer ( P = .035), those treated with curative intent ( P = .003), and those with a lower CD4 cell count ( P = .036). Advanced stage and poor treatment completion contributed to high mortality overall. Conclusion In the context of good access to and use of antiretroviral treatment in Botswana, HIV infection significantly decreases cervical cancer survival.

Download Full-text

Risk Factors for Invasive Cervical Cancer in Kenyan Women

International Journal of Epidemiology ◽

10.1093/ije/23.5.906 ◽

1994 ◽

Vol 23 (5) ◽

pp. 906-912 ◽

Cited By ~ 22

Author(s):

MICHELLE A WILLIAMS ◽

PATRICK R KENYA ◽

J K G MATI ◽

DAVID B THOMAS

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

Invasive Cervical Cancer ◽

Kenyan Women

Download Full-text

Effect of HIV Infection on Human Papillomavirus Types Causing Invasive Cervical Cancer in Africa

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001113 ◽

2016 ◽

Vol 73 (3) ◽

pp. 332-339 ◽

Cited By ~ 36

Author(s):

Gary M. Clifford ◽

Hugo de Vuyst ◽

Vanessa Tenet ◽

Martyn Plummer ◽

Stephen Tully ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Hiv Infection ◽

Invasive Cervical Cancer

Download Full-text

Cervical Intraepithelial Neoplasia and Human Papillomavirus Infection among Senegalese Women Seropositive for HIV-1 or HIV-2 or Seronegative for HIV

International Journal of STD & AIDS ◽

10.1177/095646249400500307 ◽

1994 ◽

Vol 5 (3) ◽

pp. 189-193 ◽

Cited By ~ 24

Author(s):

Awa Coll Seek ◽

Mama Awa Faye ◽

Cathy W Critchlow ◽

Adia Diack Mbaye ◽

Jane Kuypers ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Hiv Infection ◽

Invasive Cervical Cancer ◽

Intraepithelial Neoplasia ◽

Hpv Infection ◽

African Countries ◽

Increased Risk ◽

Hpv Types ◽

Hiv 1

Studies in various regions of the world have shown that women infected with HIV-1 are at increased risk for cervical human papillomavirus (HPV) infection as well as for cervical cancer precursor lesions. HIV infection and cervical cancer are both widespread in West Africa, but little is known about the relationship between HPV and HIV-2, which is the predominant type of HIV in the general population of many West African countries. To address this issue, we collected cervical samples for cytology and HPV analysis from 93 women presenting to the University of Dakar Infectious Disease Service (18 women with HIV-1 infection, 17 with HIV-2 infection, and 58 HIV seronegative controls). Compared to those without HIV infection, HIV seropositive women were 13.1 (95% CI = 2.4, 128) and 11.0 (95% CI = 3.5, 35.8) times more likely to have HPV detected using Southern transfer hybridization (STH) and the polymerase chain reaction (PCR) respectively. Detection of high and intermediate risk HPV types were significantly associated with HIV-1 and HIV-2 infection. Among HPV positive women, those with, as compared to those without HIV infection were more likely to harbour high risk HPV types (OR = 9.2, 95% CI = 0.97, 433). HIV-1 and HIV-2 seropositive women were 23.3 (95% CI = 2.9, 209) and 9.3 (95% CI = 1.1, 79) times more likely to have a cytological diagnosis of dysplasia, respectively, than were HIV seronegative women. Biopsy-proven CIN 3 was found in one woman with HIV-1 and invasive cancer was found in one woman with HIV-2. It remains to be seen whether HIV-1 and HIV-2 will confer similar risks of development of CIN 2–3 and potentially of invasive cervical cancer.

Download Full-text

Changes in The Burden of HIV-Related Cervical Cancer Over A Decade in Côte d’Ivoire

10.21203/rs.3.rs-111734/v1 ◽

2020 ◽

Author(s):

Antoine Jaquet ◽

Simon Boni ◽

Boris Tchounga ◽

Kouassi Comoe ◽

Aristophane Tanon ◽

...

Keyword(s):

Cervical Cancer ◽

Hiv Infection ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Clinical Stage ◽

Invasive Cervical Cancer ◽

Sub Saharan Africa ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Time Periods

Abstract BACKGROUND: Major improvements have occurred in access to antiretroviral treatment (ART) and invasive cervical cancer (ICC) prevention of HIV-infected women over the past decade in sub-Saharan Africa. However, there is limited information on changes in the burden of HIV-related ICC at a population level. Our objective was to compare HIV-related ICC over a decade and document factors associate with HIV infection in women with ICC in Côte d’Ivoire.METHODS: A repeated cross-sectional study was conducted in referral hospitals of Abidjan, Côte d’Ivoire during the 2009-2011 and 2018-2020 periods. During both periods, women diagnosed with ICC were systematically tested for HIV. A common questionnaire was administered to collect demographic information, ICC risk factors, cancer stage (FIGO) and HIV characteristics (ART use, last known CD4 count) for those screened positive. Characteristics of HIV-related ICC were compared between the time periods and factors associated with HIV in women diagnosed with ICC in 2018-2020 were documented through a multivariate logistic model.RESULTS: During the 2009-2011 and 2018-2020 periods, 147 and 297 women with ICC were diagnosed, with median [IQR] age at ICC diagnosis of 49 [40-57] years and 51 [43-60] years (p=0.01), respectively. The estimated HIV prevalence was 24.5% and 21.9% (p=0.53), respectively. An advanced FIGO stage (III, IV) was documented in 74.5% and 76.2% of women during these two time periods (p=0.72). In HIV-infected women, access to ART increased from to 2.8% to 73.8% (p<10-4) and median CD4 cell count from 285 [IQR 250 – 441] to 492 [IQR 377 – 833] cells/mm3 (p=0.03) between the two time periods. In Women diagnosed with ICC during the 2018-2020 period, HIV infection was associated with a less advanced clinical stage (FIGO I/II stage) [aOR=2.2 (95%CI 1.1-4.4)] and with higher ICC diagnosis through a systematic screening [aOR=10.5 (95%CI 2.5-45.5)].CONCLUSIONS: Despite an improved access to ART in Côte d’Ivoire, the proportion of HIV-infected women diagnosed with ICC remains high in 2020. HIV-infected women diagnosed with ICC in 2018-2020 presented with less advanced stage and a higher access to ICC screening at diagnosis compared to their uninfected counterparts suggesting an enhanced access to early ICC diagnosis.

Download Full-text