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

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.

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

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e17504 ◽

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.

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Detection and Associated Factors for Cervical Precancerous Lesions Among HIV-Positive Women from High HIV-Burden Areas — China, 2015−2016

China CDC Weekly ◽

10.46234/ccdcw2020.092 ◽

2020 ◽

Vol 2 (20) ◽

pp. 355-361

Author(s):

Yaping Qiao ◽

◽

Ailing Wang ◽

Xiaoyan Wang ◽

Qian Wang ◽

...

Keyword(s):

Associated Factors ◽

Precancerous Lesions ◽

Hiv Positive ◽

Hiv Positive Women ◽

Cervical Precancerous Lesions

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HIV-positive women have higher risk of human papilloma virus infection, precancerous lesions, and cervical cancer

AIDS ◽

10.1097/qad.0000000000001765 ◽

2018 ◽

Vol 32 (6) ◽

pp. 795-808 ◽

Cited By ~ 52

Author(s):

Gui Liu ◽

Monisha Sharma ◽

Nicholas Tan ◽

Ruanne V. Barnabas

Keyword(s):

Cervical Cancer ◽

Virus Infection ◽

Human Papilloma Virus ◽

Precancerous Lesions ◽

Human Papilloma Virus Infection ◽

Hiv Positive ◽

Papilloma Virus ◽

Hiv Positive Women

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Faculty Opinions recommendation of Carcinogenicity of Human Papillomavirus (HPV) Types in HIV-Positive Women: A Meta-Analysis From HPV Infection to Cervical Cancer.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727565191.793546767 ◽

2018 ◽

Author(s):

Santosh Kumar

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Meta Analysis ◽

Hpv Infection ◽

Hiv Positive ◽

Hiv Positive Women ◽

Hpv Types

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Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study

International Journal of Health Geographics ◽

10.1186/s12942-021-00283-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Dhokotera Tafadzwa ◽

Riou Julien ◽

Bartels Lina ◽

Rohner Eliane ◽

Chammartin Frederique ◽

...

Keyword(s):

South Africa ◽

Health Care ◽

Cervical Cancer ◽

South African ◽

Access To Health Care ◽

Health Facilities ◽

Hiv Positive ◽

The South ◽

Hiv Positive Women ◽

Access To Health

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

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The application of CRISPR/Cas9 system in cervical carcinogenesis

Cancer Gene Therapy ◽

10.1038/s41417-021-00366-w ◽

2021 ◽

Author(s):

Chun Gao ◽

Ping Wu ◽

Lan Yu ◽

Liting Liu ◽

Hong Liu ◽

...

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Transgenic Mice ◽

Cell Line ◽

Cell Lines ◽

Cancer Cell ◽

Precancerous Lesions ◽

Cancer Cell Lines ◽

Cervical Carcinogenesis ◽

Cervical Precancerous Lesions

AbstractIntegration of high-risk HPV genomes into cellular chromatin has been confirmed to promote cervical carcinogenesis, with HPV16 being the most prevalent high-risk type. Herein, we evaluated the therapeutic effect of the CRISPR/Cas9 system in cervical carcinogenesis, especially for cervical precancerous lesions. In cervical cancer/pre-cancer cell lines, we transfected the HPV16 E7 targeted CRISPR/Cas9, TALEN, ZFN plasmids, respectively. Compared to previous established ZFN and TALEN systems, CRISPR/Cas9 has shown comparable efficiency and specificity in inhibiting cell growth and colony formation and inducing apoptosis in cervical cancer/pre-cancer cell lines, which seemed to be more pronounced in the S12 cell line derived from the low-grade cervical lesion. Furthermore, in xenograft formation assays, CRISPR/Cas9 inhibited tumor formation of the S12 cell line in vivo and affected the corresponding protein expression. In the K14-HPV16 transgenic mice model of HPV-driven spontaneous cervical carcinogenesis, cervical application of CRISPR/Cas9 treatment caused mutations of the E7 gene and restored the expression of RB, E2F1, and CDK2, thereby reversing the cervical carcinogenesis phenotype. In this study, we have demonstrated that CRISPR/Cas9 targeting HPV16 E7 could effectively revert the HPV-related cervical carcinogenesis in vitro, as well as in K14-HPV16 transgenic mice, which has shown great potential in clinical treatment for cervical precancerous lesions.

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Raman spectroscopic study of cervical precancerous lesions and cervical cancer

Lasers in Medical Science ◽

10.1007/s10103-020-03218-5 ◽

2021 ◽

Author(s):

Jing Wang ◽

Cheng-Xia Zheng ◽

Cai-Ling Ma ◽

Xiang-Xiang Zheng ◽

Xiao-Yi Lv ◽

...

Keyword(s):

Cervical Cancer ◽

Squamous Cell Carcinoma ◽

Raman Spectra ◽

Precancerous Lesions ◽

Cervical Squamous Cell Carcinoma ◽

Cervical Lesions ◽

Cin Iii ◽

Cervical Precancerous Lesions ◽

Biochemical Components ◽

The Difference

AbstractEarly detection of cervical lesions, accurate diagnosis of cervical lesions, and timely and effective therapy can effectively avoid the occurrence of cervical cancer or improve the survival rate of patients. In this paper, the spectra of tissue sections of cervical inflammation (n = 60), CIN (cervical intraepithelial neoplasia) I (n = 30), CIN II (n = 30), CIN III (n = 30), cervical squamous cell carcinoma (n = 30), and cervical adenocarcinoma (n = 30) were collected by a confocal Raman micro-spectrometer (LabRAM HR Evolution, Horiba France SAS, Villeneuve d’Ascq, France). The Raman spectra of six kinds of cervical tissues were analyzed, the dominant Raman peaks of different kinds of tissues were summarized, and the differences in chemical composition between the six tissue samples were compared. An independent sample t test (p ≤ 0.05) was used to analyze the difference of average relative intensity of Raman spectra of six types of cervical tissues. The difference of relative intensity of Raman spectra of six kinds of tissues can reflect the difference of biochemical components in six kinds of tissues and the characteristic of biochemical components in different kinds of tissues. The classification models of cervical inflammation, CIN I, CIN II, CIN III, cervical squamous cell carcinoma, and cervical adenocarcinoma were established by using a support vector machine (SVM) algorithm. Six types of cervical tissues were classified and identified with an overall diagnostic accuracy of 85.7%. This study laid a foundation for the application of Raman spectroscopy in the clinical diagnosis of cervical precancerous lesions and cervical cancer.

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Cervical cancer screening service utilization and associated factors among HIV positive women attending adult ART clinic in public health facilities, Hawassa town, Ethiopia: a cross-sectional study

BMC Health Services Research ◽

10.1186/s12913-019-4718-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 6

Author(s):

Abiyu Ayalew Assefa ◽

Feleke Hailemichael Astawesegn ◽

Bethlehem Eshetu

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cross Sectional Study ◽

Partner Support ◽

Hiv Positive ◽

Screening Service ◽

Hiv Diagnosis ◽

Cross Sectional ◽

Hiv Positive Women

Abstract Background In Ethiopia, cervical cancer is a public health concern, as it is the second most cause of cancer deaths among reproductive age women and it affects the country’s most vulnerable groups like; rural, poor, and HIV-positive women. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, its utilization remains low. Methods An institution-based cross-sectional study was conducted from March 2 to April 1/2019 to assess the level and factors affecting utilization of cervical cancer screening among HIV positive women in Hawassa town. Quantitative data collection methods were used. Data were gathered using a structured and pretested questionnaire. Epi-Info version 7 and SPSS version 23 were used for data entry and analysis respectively. Statistically significant association of variables was determined based on Adjusted Odds ratio with its 95% confidence interval and p-value of ≤0.05. Results Of the 342 women interviewed, 40.1% (95% CI: 35.00, 45.33%) of them were screened. Having a post primary education (AOR = 5.1, 95% CI: 1.8, 14.5), less than 500 cell/mm3 CD4 count (AOR = 2.7, 95% CI: 1.2, 5.9); duration since HIV diagnosis (AOR = 4.2, 95% CI: 2.1, 8.5), partner support (AOR = 4.7, 95% CI: 2.3, 9.4), having knowledge about risk factors (AOR = 2.9 (95% CI: 1.2, 6.9) and having favorable attitude towards cervical cancer and its screening (AOR = 3.7 (95% CI: 1.8, 7.5) were associated with cervical cancer screening utilization. Conclusions The study revealed utilization of cervical cancer screening service was low among HIV positive women. Educational status, duration of HIV diagnosis, partner support, knowledge status about risk factor, CD4 count and attitude towards cervical cancer and its screening were associated with cervical cancer screening utilization. Health care workers need to provide intensive counseling services for all ART care attendants to increase utilization.

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