Accelerated epigenetic age among HIV-infected Nigerian women with invasive cervical cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17504-e17504
Author(s):  
Jonah Musa ◽  
Kyeezu Kim ◽  
Yinan Zheng ◽  
Lois B. Travis ◽  
Demirkan Gursel ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Hiv Positive ◽  
Cervical Tissue ◽  
Nigerian Women ◽  
Normal Tissues ◽  
Hiv Positive Women ◽  
Epigenetic Age ◽  
Tumor Tissues ◽  
Hiv Negative

e17504 Background: Invasive cervical cancer (ICC) is one of the HIV-associated cancers with a high burden in Nigeria. ICC occurs at relatively younger age in HIV infected women, with HIV known to promote aging and related diseases, including cancer. DNA methylation changes with increasing age, various health-related exposures, and age-related health outcomes, suggesting a role of DNA methylation in biological aging and disease. We sought to understand the effect of HIV infection on epigenetic age acceleration (EpiAgeAccel) in Nigerian women with ICC. Methods: Epigenetic age (EpiAge) was estimated by Horvath’s calculator using genome-wide methylation data in 116 cervical tissue samples from three groups of women: a) HIV positive with ICC (n=39); b) HIV positive and cancer-free (n=53); and c) HIV negative with ICC (n=24). EpiAgeAccel was computed as the regression residuals of EpiAge against chronological age (ChronAge), representing the independent deviation of EpiAge from ChronAge. We compared EpiAgeAccel across the 3 HIV/ICC groups using multiple linear regressions adjusting for ChronAge, education, parity, employment, cancer stage, body mass index, and study site. Among the ICC women, we compared EpiAgeAccel between 26 tumor tissues and their surrounding normal tissues using paired t-tests, stratified by HIV status. Results: EpiAgeAccel among HIV positive women with ICC was 4.5 years higher than HIV positive and cancer-free women (p=0.019). We did not find substantial differences in EpiAgeAccel between HIV-positive women with ICC and HIV-negative women with ICC. EpiAgeAccel was 7.9 and 2.9 years higher in tumor tissues compared to the surrounding normal tissues among HIV positive women (p=0.021) and negative women (p=0.295), respectively. Conclusions: EpiAge is accelerated in cervical tissue of HIV-infected women with ICC. EpiAgeAccel may be a potential biomarker for ICC screening and early detection for women living with HIV in low- and middle-income countries.

Abstract 71: Accelerated Epigenetic Age among HIV-infected Nigerian Women with Invasive Cervical Cancer

2021 ◽  
Author(s):  
Jonah Musa ◽  
Kyeezu Kim ◽  
Yinan Zheng ◽  
Yishu Qu ◽  
Brian Joyce ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Invasive Cervical Cancer ◽  
Nigerian Women ◽  
Epigenetic Age

scholarly journals Human papillomavirus type-specific risk of cervical cancer in a population with high human immunodeficiency virus prevalence: case–control study

2011 ◽  
Vol 92 (12) ◽  
pp. 2784-2791 ◽  
Author(s):  
Pontus Naucler ◽  
Flora Mabota da Costa ◽  
Joao Leopoldo da Costa ◽  
Otto Ljungberg ◽  
Antonio Bugalho ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Immunodeficiency Virus ◽  
Human Papillomavirus ◽  
Effect Modification ◽  
Hiv Positive ◽  
Hpv 16 ◽  
Cervical Cancer Risk ◽  
Hiv Positive Women ◽  
Immunodeficiency Virus ◽  
Hiv Negative

There are limited data on human papillomavirus (HPV) type-specific cervical cancer risk among human immunodeficiency virus (HIV)-positive women. Previous studies have suggested that HPV 16 would be relatively less important as a causative agent among HIV-positive compared with HIV-negative women. This study investigates HPV type-specific cervical cancer risk in a population in which HIV is endemic. At the Central Hospital, Maputo, Mozambique, 221 cervical cancer cases and 203 hospital-based controls were consecutively enrolled. HPV typing from cervical samples, HIV testing and recording of socio-demographic factors were performed. Logistic regression modelling was used to assess HPV type-specific risk and effect modification between HIV and HPV infection. Infection with HPV 16, 18 and ‘high-risk non-HPV 16/18 types’ (HPV 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59) was associated with cervical cancer in both crude and adjusted analyses. HPV 16 and 18 were the most common types detected in cancer biopsies among both HIV-negative and HIV-positive women. There was no significant evidence of effect modification between any HPV type and HIV infection, and there were no significant differences in the HPV type-specific prevalence when cervical cancers among HIV-positive and HIV-negative women were compared. Within the limitations of the study, the relative importance of different HPV types in cervical carcinogenesis appears not to be modified greatly by HIV infection, suggesting that HPV vaccines might not need to be type-specifically modified to be suitable for populations where HIV is endemic.

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 Influence of HIV/AIDS on Cervical Cancer: A Retrospective Study From Tanzania

2017 ◽  
Vol 3 (1) ◽  
pp. 72-78 ◽  
Author(s):  
Ramadhani S. Chambuso ◽  
Stephen Shadrack ◽  
Salum J. Lidenge ◽  
Ntoli Mwakibete ◽  
Rui M. Medeiros
Keyword(s):  
Cervical Cancer ◽  
Retrospective Study ◽  
Precancerous Lesions ◽  
Invasive Cervical Cancer ◽  
Health Concern ◽  
Hiv Positive ◽  
Significant Implication ◽  
Hiv Positive Women ◽  
Cervical Precancerous Lesions ◽  
Hiv Aids

Purpose Cervical cancer is the leading cause of cancer-related morbidity and mortality in women in Tanzania. Any impact of the HIV/AIDS epidemic on cervical precancerous lesions and invasive cervical cancer has a significant implication, as for any public health concern, especially in an area such as the Morogoro region in Tanzania, which has one of the highest rates of cervical cancer in the world. Methods A comparative retrospective study was performed of 536 women screened for cervical cancer by visual inspection methods at the Morogoro Regional Referral Hospital over a period of 3 years; the women were grouped according to their HIV status. The odds ratios (OR) with 95% CIs were estimated using χ2 test and multivariate analysis. The test statistics were evaluated with a significance level of P < .05. Results The prevalence of precancerous lesions was 71.8% in HIV-positive women and 27.3% in HIV-seronegative women. Furthermore, the prevalence of extensive or large precancerous lesions was 40.5% in HIV-positive women and 13.5% in HIV-seronegative women. The prevalence of invasive cervical cancer was 8% in HIV-seronegative women and 11% in HIV-positive women. The risk factors for the cervical lesions were HIV-positive status (OR, 6.8; 95% CI, 4.2 to 11.2; P < .001) and being older than 30 years of age (OR, 11.99; 95% CI, 6.86 to 21.21; P < .001). Conclusion HIV/AIDS has a highly statistically significant association with ( P < .001) and a great influence on the development of cervical precancerous lesions in HIV-positive women; however, its direct involvement in the progression to invasive cervical cancer, especially in this era of highly active antiretroviral therapy, is questionable.

scholarly journals Features of papillomavirus infection in HIV-infected women

2012 ◽  
Vol 17 (4) ◽  
pp. 9-11
Author(s):  
E. S Sverdlova ◽  
T. V Dianova
Keyword(s):  
Cervical Cancer ◽  
Significant Contribution ◽  
Intraepithelial Neoplasia ◽  
Hpv Infection ◽  
Hiv Positive ◽  
Papillomavirus Infection ◽  
Hiv Positive Women ◽  
Selection Of Patients ◽  
Selection Of ◽  
Hiv Negative

As participation of immune system in the protection of human papillomavirus (HPV) has been proven, the incidence of HPV infection leading to cervical intraepithelial neoplasia (CIN) among HIV-positive women is 4 times higher than in HIV-negative cases. In the presence of HIV HPV implements oncoprogram during 6-12 months. Сytokine imbalance makes a significant contribution to the progression of HIV in combination with HPV. The criteria of selection of patients with HIV for therapy cytokines in CIN 2-3 (Roncoleukin used in the author's scheme). Using Ronkoleukin in combination with HAART in HIV-positive women can delay the progression of CIN 2-3 in cervical cancer. The criteria of selection of HIV female patients for the therapy with cytokines at the 2-3 stage of CIN ( Roncoleukin was used in the author's scheme) have been detected. Application Roncoleukin in combination with HAART in HIV-positive women can delay the progression of cervical cancer at the CIN 2-3 stage.

Global line-1 hypomethylation as novel biomarker for cervical cancer in Nigerian women living with HIV.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17513-e17513
Author(s):  
Yinan Zheng ◽  
Jonah Musa ◽  
Brian Thomas Joyce ◽  
Jun Wang ◽  
Demirkan Gursel ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Hiv Infection ◽  
Dna Sequences ◽  
Human Endogenous Retrovirus ◽  
Hiv Positive ◽  
P Value ◽  
Women Living With Hiv ◽  
Hiv Positive Women ◽  
Living With Hiv ◽  
Hiv Negative

e17513 Background: Nigeria faces a high health burden of cervical cancer (CC), which is worsened by high prevalence of human immunodeficiency virus (HIV) infection. Repetitive elements (RE) are DNA sequences that occur in multiple copies throughout the human genome. HIV infection can lead to RE hypomethylation that causes genome instability, an event often seen in the early phase of tumorigenesis. We aim to examine global RE hypomethylation as a novel epigenetic biomarker for CC among HIV-positive women in Nigeria. Methods: This study involved three groups of women: a) HIV-positive with CC (n=39); b) HIV-positive and cancer-free (n=52); and c) HIV-negative with CC (n=23). We estimated three types of global RE methylation in cervical tissue using genome-wide methylation data: long interspersed nuclear elements (LINE-1), Alu, and human endogenous retrovirus (HERV). We used multiple linear regression adjusting for age, education, parity, employment, cancer stage, body mass index, and sample batch to compare the biomarkers across the HIV/ICC groups and paired t-test to compare 26 pairs of tumor vs. surrounding normal tissues, stratified by HIV status. Receiver operating characteristic curve (ROC) and area under the ROC (AUC) were used to examine the diagnostic value. Results: Among HIV-positive women, all 3 global RE methylation biomarkers were hypomethylated in CC compared to cancer-free (LINE-1: mean difference [MD]=-0.049, p-value=2.9e-8; Alu: MD=-0.011, p-value=2.0e-4; HERV: MD=-0.013, p-value=1.7e-6). Paired analyses showed a larger, more significant MD in HIV-positive stratum than HIV-negative, especially LINE-1 (MD=-0.048 vs. -0.020, p-value=0.004 vs. 0.254). LINE-1 achieved the highest AUC (0.85, 95% CI: 0.76-0.95) in distinguishing tumor tissue from normal tissue among HIV-positive women, followed by HERV (0.82, 95% CI: 0.73-0.92) and Alu (0.60, 95% CI: 0.47-0.72). Conclusions: Global LINE-1 hypomethylation may serve as a novel biomarker for CC screening and early detection for women living with HIV in low- and middle-income countries.

scholarly journals Knowledge and experience of a cohort of HIV-positive and HIV-negative Ghanaian women after undergoing human papillomavirus and cervical cancer screening

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Arabella Stuart ◽  
Dorcas Obiri-Yeboah ◽  
Yaw Adu-Sarkodie ◽  
Anna Hayfron-Benjamin ◽  
Angela D. Akorsu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Health Workers ◽  
Cervical Screening ◽  
Knowledge Score ◽  
Hpv Infection ◽  
Hiv Positive ◽  
Hiv Status ◽  
Hiv Positive Women ◽  
Screening Study ◽  
Hiv Negative

Abstract Background Cervical cancer is the most common cancer in women in Ghana, but knowledge and experience of women who have had cervical screening is under-evaluated. This study examined knowledge and understanding of HPV and cervical cancer and evaluated experiences of screening in a cohort of women of mixed HIV status. Methods This was a mixed methods study using questionnaires and focus group discussions, with a knowledge score constructed from the questionnaire. HIV-positive and HIV-negative women were recruited from a larger cervical screening study in Ghana and were interviewed 6 months after receiving screening. Quantitative data was analyzed and triangulated with qualitative data following thematic analysis using the framework approach. Results A total of 131 women were included (HIV-positive, n = 60). Over 80% of participants had a knowledge score deemed adequate. There was no difference between HIV-status groups in overall knowledge scores (p = 0.1), but variation was seen in individual knowledge items. HIV-positive women were more likely to correctly identify HPV as being sexually-transmitted (p = 0.05), and HIV negative women to correctly identify the stages in developing cervical cancer (p = < 0.0001). HIV-positive women mostly described acquisition of HPV in stigmatising terms. The early asymptomatic phase of cervical cancer made it difficult for women to define “what” cancer was versus “what” HPV infection was. All women expressed that they found it difficult waiting for their screening results but that receiving information and counselling from health workers alleviated anxiety. Conclusions Knowledge of women who had participated in a cervical screening study was good, but specific misconceptions existed. HIV-positive women had similar levels of knowledge to HIV-negative, but different misconceptions. Women expressed generally positive views about screening, but did experience distress. A standardized education tool explaining cervical screening and relevance specifically of HPV-DNA results in Ghana should be developed, taking into consideration the different needs of HIV-positive women.

scholarly journals The Study of Prevalence, Knowledge, Attitude, Beliefs and Practice of Cervical Cancer in HIV Positive Women in Purdah and HIV Positive Women Not in Purdah in Gombe State Nigeria

2021 ◽  
pp. 45-57
Author(s):  
S. Umar ◽  
J. O. Adisa ◽  
O. O. Okechi ◽  
U. Abubakar ◽  
A. B. Imam
Keyword(s):  
Cervical Cancer ◽  
Sample Size ◽  
Pap Smear ◽  
Sexual Partners ◽  
Hiv Positive ◽  
Early Age ◽  
Hiv Positive Women ◽  
Beliefs And Practice ◽  
Male Sexual Partners ◽  
Hiv Negative

Introduction: Purdah or pardah is a Persian word which translated loosely to mean ‘curtain’, is a religious and social practice of female seclusion prevalent among some Muslim communities.  In stating the reasons for the need of purdah, the Qu’ran declares that “the observance of hijab is so that the (pure and pious women) may be recognized and not be molested” Cervical cancer is a malignant disease of the cervix. The disease has a pre-malignant stage which usually occurs in younger women.  Carcinoma of the cervix is associated with the following risk factors; early age at first sexual intercourse, multiple male sexual partners,  male sexual partners who have had multiple partners, early age at first birth, multiparty, smoking, long-term use of oral contraceptive pills, immunosuppressed states. Cervical cancer is preventable through vaccination and can be easily diagnosed, but prevention and diagnostic programmes are not widely available in the developing world (Branca et al., 2003). Rates of cervical cancer are four to five times higher among women living with HIV than among HIV negative women, while the overall risk of acquiring HIV among women doubles when women are infected with the human papillomavirus, a cause of cervical cancer. Aim: To study the Prevalence, Knowledge, Attitude, Beliefs and Practice of cervical cancer in HIV positive women in purdah and HIV positive women not in purdah, and relate this to the prevalence of cervical cancer. Methods: The study was a cross-sectional study to determine the prevalence of cervical cancer among HIV positive women in purdah attending the anti retroviral therapy (ART) Clinic of the Federal Teaching Hospital, Gombe. A sample size of 150 each was used for both the subject group and controls. HIV positive women in purdah=150 subjects, HIV positive women not in purdah= 150 subjects and HIV negative women not in purdah =150 subjects. Sample size equals 450 to give room for alteration. Results: Results collected using the questionnaire revealed that only a mean of about 41 (27.3%) HIV positive women in purdah had correct knowledge of Cervical Cancer as compared with HIV positive women not in purdah who had a mean of 129 (86.0%)  and 114 (76.7%)  for  HIV negative women not in purdah.  Large percentage of 61.3% of HIV positive women in Purdah, 86.0% of HIV positive women not in purdah and 76.7% of HIV negative women not in purdah, had previous knowledge of Cervical Cancer. The knowledge about the link between early marriages to increased risk of cervical cancer was not low amongst HIV positive women in purdah (34.7%) but this was not the case with their counterparts as 86.0% of HIV positive women not in purdah and 80.7% of HIV negative women in purdah were knowledgeable about the link. Not less than 95% of women in all groups expressed   indifference towards the gender of the personnel collecting the Pap smear nevertheless some still showed some reluctance towards having their pap smear collected by personnel of the opposite sex. Women in purdah showed the highest percentage of this reluctance (4.7%).  As regards to practices, the women in purdah had a mean positive practice of 63.3% as against 58.7% and 60.8% respectively of the control group (HIV positive women not in purdah and HIV negative women not in purdah). Women in purdah had a higher positive practice in all cases except the issues of husbands deciding the number of children (16.7% -HIV positive women in purdah, 88.0% -HIV positive women not in purdah and 100% -HIV negative women not in purdah) and husbands deciding when to stop having children (35.5% -HIV positive women in purdah, 52.0% -HIV positive women not in purdah and 43.3% -HIV negative women not in purdah). Conclusion: The prevalence of cervical lesions in HIV positive women in purdah (42.0%) is higher than that of HIV negative women not in purdah (16.0%), but lower than that of HIV positive women not in purdah (56.0%).Hiv positive women in purdah had the lowest knowledge of cervical cancer with a mean score of (27.3%) while the control groups had a higher knowledge of 86.0% and 76.7% respectively. This implies that there is need for comprehensive and correct knowledge, positive attitude/ beliefs and positive behavioral practice are important in the control of cervical cancer and diseases in general.

scholarly journals Assessing national cervical cancer screening guidelines: Results from an HIV testing clinic also screening for cervical cancer and HPV in Soweto, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255124
Author(s):  
Kathryn L. Hopkins ◽  
Maya Jaffer ◽  
Khuthadzo E. Hlongwane ◽  
Kennedy Otwombe ◽  
Janan Dietrich ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Older Women ◽  
Cervical Cancer Screening ◽  
Pap Smear ◽  
Hiv Positive ◽  
Pap Smears ◽  
Hiv Status ◽  
Hiv Positive Women ◽  
Hiv Negative

Objective A screening centre in Soweto, South Africa (SA), investigated high-risk human papillomavirus (HR-HPV), HIV, cervical cancer risk amongst women. Methods This cross-sectional study (June 2018-March 2019) describes screening results (Roche Linear Array HPV test and Pap smear liquid based cytology) and history of screening (known HIV status, antiretroviral therapy [ART] use, previous Pap smears). Data were stratified by age group (18–29, 30+ years), HIV status, Pap smear results and tested for statistical significance. Results Of 280 women, 20.4% were HIV-positive, 18.2% had abnormal Pap smears, 41.8% had HR-HPV. Of older women, 48.2% (n = 78/162) had never had a Pap smear. Of younger women, 89.0% (n = 105/118) never had a Pap smear, but had significantly more low-grade squamous intraepithelial lesions (LSIL) and other HR-HPV infection than older women (12.7%[n = 15/118] vs 4.9%[n = 8/162], p = 0.0193; and 49.2%[n = 58/118] vs 29.0%[n = 47/162], p = 0.0006; respectively). HIV-positive women had more abnormal cytology results and infection with other HR-HPV types or co-infection with other HR-HPV type(s)/HPV-16 compared to HIV-negative women (35.1%[n = 20/57] vs 13.9%[n = 31/223], p = 0.0002; 56.1%[n = 32/57] vs 32.7%[n = 73/223], p = 0.001; and 12.3%[n = 7/57] vs 4.9%[n = 11/223], p = 0.044; respectively). Of 57 HIV-positive women, 45.6% (n = 26) already knew their HIV status; of which 69.2% were on ART and 34.6% never had a Pap smear. Conclusion South African women have high rates of HIV, Pap smear abnormalities and HR-HPV, with low cervical cancer screening coverage. SA cervical cancer screening policy excludes (undiagnosed) HIV-positive and HIV-negative women <30 years, both populations found to have high prevalence of HR-HPV. HPV-based primary screening from 25 years could improve outcomes.

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