scholarly journals Prevalence of cervical abnormalities amongst HIV-positive women

2021 ◽  
Vol 8 (2) ◽  
pp. 230-234
Author(s):  
Amisha Gheewala ◽  
Suchita Patel ◽  
Ragini Verma
Keyword(s):  
Pap Smear ◽  
Statistical Significance ◽  
Hpv Infection ◽  
P Value ◽  
Hiv Positive Women ◽  
Pap Smear Screening ◽  
History Of ◽  
Epithelial Lesions ◽  
Hiv Seropositive ◽  
Asymptomatic Hiv

To study the prevalence and variety of cervical squamous intra-epithelial lesions (SIL) by Pap smear screening as an indicator of suspected HPV infection among HIV-infected women in Surat, Gujarat, India.All consecutive asymptomatic HIV seropositive women 18 years and older and attending the Anti-Retroviral Therapy Centre at New Civil Hospital, Surat, India between October 2009 to September 2011 were eligible for inclusion in the study. Participants constituted 439 asymptomatic HIV seropositive women receiving care at the ART centre underwent detailed history taking, physical examination and Pap smear screening. The incidence of SIL was 8.7% (38/439) in the participants. Further, statistical significance (p value > 0.05) was observed in parity more than two, lost their husband, duration of marriage more than 10 years and CD4 count greater than 250.An association between HIV infection with pre-invasive changes in the cervical epithelium is noted. Early detection and prompt treatment of these changes after a thorough understanding of the natural history of disease in these women would go a long way in improving the survival as well as the quality of life in this increasing seropositive younger population.

scholarly journals The Relationship between Cocaine Use and Human Papillomavirus Infections in HIV-Seropositive and HIV-Seronegative Women

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
Howard Minkoff ◽  
Ye Zhong ◽  
Howard D. Strickler ◽  
D. Heather Watts ◽  
Joel M. Palefsky ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Pap Smear ◽  
Crack Cocaine ◽  
Hpv Infection ◽  
Cocaine Use ◽  
Hpv Dna ◽  
Increased Risk ◽  
Hiv Seropositive ◽  
Oncogenic Hpv

Objective. Animal data suggest that cocaine has an immunosuppressive effect, but no human studies have been conducted to assess the relation of cocaine use with human papillomavirus (HPV) infection, the viral cause of cervical cancer. Since both cocaine use and HPV infection are common among HIV-positive women, we sought to determine whether use of cocaine and/or crack influences the natural history of HPV among women with or at high risk of HIV.Methods. Women enrolled in the Women's Interagency HIV Study (2278 HIV-seropositive and 826 high-risk seronegative women) were examined every six months for up to 9.5 years with Pap smear, collection of cervicovaginal lavage (CVL) samples, and detailed questionnaires regarding health and behavior, including use of crack and cocaine (crack/cocaine). CVLs were tested for HPV DNA by PCR, with genotyping for over forty HPV types.Results. In multivariate logistic regression models, censoring women treated for cervical neoplasia, crack/cocaine use within the last six months was associated with prevalent detection of oncogenic HPV DNA (odds ratio [OR] = 1.30 (1.09–1.55)), and with oncogenic HPV-positive squamous intraepithelial lesions (SIL) (OR = 1.70 (1.27–2.27)), following adjustment for age, race, HIV-serostatus, and CD4+ T-cell count, the number of sexual partners in the past six months, and smoking. In multivariate Cox models crack/cocaine use was also associated with a trend that approached significance in regard to incident detection of oncogenic HPV-positive SIL (HR = 1.51, 95% CI 0.99–2.30), and while the rate of oncogenic HPV clearance was not related to cocaine use, the clearance of any SIL was significantly lower in those with versus those without recent crack/cocaine use (HR = 0.57, 95% CI 0.34–0.97).Conclusions. Cocaine use is associated with an increased risk of detection of both prevalent and incident oncogenic HPV infection, as well as an increased risk of HPV-positive SIL over time.

scholarly journals Self-reported history of Pap-smear in HIV-positive women in Northern Italy: a cross-sectional study

BMC Cancer ◽  
2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Luigino Dal Maso ◽  
◽  
Silvia Franceschi ◽  
Mauro Lise ◽  
Priscilla Sassoli de' Bianchi ◽  
...  
Keyword(s):  
Pap Smear ◽  
Cross Sectional Study ◽  
Northern Italy ◽  
Hiv Positive ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hiv Positive Women ◽  
History Of

scholarly journals Prevalence of Human Papillomavirus (HPV) Genotypes in Cervicovaginal Secretions of Human Immunodeficiency Virus (HIV) Positive Indian Women and Correlation With Clinico-Virological Parameters

2021 ◽  
Vol 3 ◽  
Author(s):  
Mahima Lall ◽  
Lalit Dar ◽  
Neerja Bhatla ◽  
Pankaj Kumar ◽  
Aashish Choudhary ◽  
...  
Keyword(s):  
Pap Smear ◽  
Hiv Positive ◽  
Squamous Intraepithelial Lesion ◽  
Hpv 16 ◽  
Cd4 Counts ◽  
Hiv Positive Women ◽  
Immunodeficiency Virus ◽  
Hpv Genotypes ◽  
Intraepithelial Lesion ◽  
Hiv Seropositive

Introduction and Background: Both human papillomavirus (HPV) and the human immunodeficiency virus (HIV) are sexually transmitted. High-risk (HR) HPV types are a causal factor in cervical cancer. Persistent HPV infection in this subset of immunocompromised women results in faster disease progression. The study determined the prevalence of HPV genotypes in cervicovaginal secretions of HIV seropositive women and the correlation with CD4 counts and cytology.Method: One hundred, non-pregnant, HIV-positive women of 18 years of age and above were enrolled in this cross-sectional study following approval by the institutional ethical committee. A written consent, questionnaire, followed by sample collection including a Papanicolaou (Pap) smear for cytology was undertaken. Cervicovaginal secretion samples were collected in the Digene® specimen transport medium (STM) (Qiagen Gaithersburg Inc., MD, USA). HPV genotyping was carried out with PCR amplification of a 65-base pair (bp) fragment in the L1 region of the HPV genome using the short PCR fragment (SPF10) primers followed by reverse hybridization by line probe assay (LPA) using the INNOLiPA HPV Genotyping Extra kit (Fujirebio, Belgium). Quantitation of HPV-16 and−18 viral loads (VLs) was done by real-time PCR. Results of Pap smear cytology were correlated with CD4 counts and HPV-16 and−18 VLs.Results: Mean age of the subjects was 34.9 years ± 7.2 years (median 33.0 years, range 24–60 years). HPV was detected in 62 of 93 (66.6%) samples. Twenty (32.25%) of these 62 samples harbored a single HPV genotype. Multiple genotypes (more than two) were detected in 38 (61.3%) samples. HPV-16 was the commonest genotype detected in 26 (27.9%) of all samples and 41.9% of HPV positive samples. Pap smear cytology was reported for 93 women included in the study. Women who had normal cytology were reported as negative for intraepithelial malignancy or lesion (NILM; n = 62; 71.36%), two women had a high-grade squamous intraepithelial lesion (HSIL), low-grade squamous intraepithelial lesion (LSIL; n = 11), atypical squamous cells of undetermined significance (ASCUS; n = 12). Those smears with inadequate material were reported as scant (n = 6). The median CD4 count was 363/cu.mm (range 39–787) in HPV-positive women compared to 423/cu.mm (range 141–996) in those HPV-negative women. Quantitation of HPV-16 and−18 VL was done in duplicate for samples positive by PCR reverse hybridization (INNOLiPA). Of these 20 samples (65%), 12 samples were positive by real-time PCR. The normalized HPV-16 VL ranged between 18 and 240,000 copies/cell. The normalized HPV-18 VL in cervical samples ranged between ~24 and 60,000 copies/cell.Conclusion: HIV-positive women may be infected with multiple genotypes other than HPV-16 and−18. This may have implications on the vaccines available currently which target few specific genotypes only. Studies are required to determine the predictive role of HR HPV genotypes, in significant copy numbers especially in HIV seropositive women. It would be clinically relevant if the HPV VLs, cervical cytology, and CD4 counts are considered into cervical cancer screening programs for triage and follow-up of these women.

scholarly journals Predicting difficult laparoscopic cholecystectomy

2018 ◽  
Vol 5 (3) ◽  
pp. 1094 ◽  
Author(s):  
Atul Kumar Gupta ◽  
Nitin Shiwach ◽  
Sonisha Gupta ◽  
Shalabh Gupta ◽  
Apoorv Goel ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Statistical Significance ◽  
Gallstone Disease ◽  
Bladder Wall ◽  
P Value ◽  
Clinical Predictors ◽  
Duration Of Symptoms ◽  
Gall Bladder Wall ◽  
History Of

Background: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for gallstone disease. Though mostly safe occasionally it can be difficult due to various problems faced during surgical procedure. Anticipation of likely difficulty can help in avoiding complications.Methods: With the aim of identifying various predictors of difficulty and their correlation with likely difficulty this prospective study on 50 adults undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis was undertaken. Various clinical, radiological and biochemical predictors and frequency and type of intraoperative difficulty was recorded.Results: In present study adverse clinical factors only showed significant predictive value (p value - 0.005). Adverse radiological predictors although showing trend towards, did not achieve statistical significance (p value 0.065). In clinical predictors duration of symptoms >1yr, History of acute cholecystitis and BMI >30 showed statistically significant association. Age >50yrs, Male gender, radiological predictors (Thickened gall bladder wall, small contracted gall bladder, Single large impacted stone) and deranged LFT did not show significant predictive value.Conclusions: Clinical predictors are most reliable factors. Use of good clinical judgement regarding possibility of and likely difficulty along with understanding of available resources is important in making decision in each case.

scholarly journals HPV Infections in Adolescents

2007 ◽  
Vol 23 (4) ◽  
pp. 229-234 ◽  
Author(s):  
Anna-Barbara Moscicki
Keyword(s):  
Treatment Strategies ◽  
Time Frame ◽  
Hpv Infection ◽  
Invasive Cancer ◽  
Low Grade ◽  
Squamous Cells ◽  
History Of ◽  
Epithelial Lesions ◽  
Short Time ◽  
Shed Light

Adolescents who are sexually active have the highest rates of prevalent and incident HPV infection rates with over 50–80% having infections within 2–3 years of initiating intercourse. These high rates reflect sexual behavior and biologic vulnerability. Most infections are transient in nature and cause no cytologic abnormality. However, a small number of adolescents will not clear the infection. Persistence of HPV is strongly linked to the development of high-grade squamous intra-epithelial lesions (HSIL) and invasive cancer. The HSIL detected, however, does not appear to progress rapidly to invasive cancer. Understanding the natural history of HPV in adolescents has shed light into optional treatment strategies which include watchful observation of atypical squamous cells of undetermined significance (ASCUS) and low grade (LSIL). The association between age of first intercourse and invasive cancer cannot be ignored. Consequently, initiating screening at appropriate times in this vulnerable group is essential. In addition, with the advent of the HPV vaccine, vaccination prior to the onset of sexual activity is critical since most infections occur within a short time frame post initiation.

scholarly journals Genome-wide association study identifies a novel susceptibility locus at 6p21.3 among familial CLL

Blood ◽  
2011 ◽  
Vol 117 (6) ◽  
pp. 1911-1916 ◽  
Author(s):  
Susan L. Slager ◽  
Kari G. Rabe ◽  
Sara J. Achenbach ◽  
Celine M. Vachon ◽  
Lynn R. Goldin ◽  
...  
Keyword(s):  
Family History ◽  
Genome Wide Association Study ◽  
Statistical Significance ◽  
Familial Risk ◽  
Lymphocytic Leukemia ◽  
Genome Wide Association ◽  
P Value ◽  
Nucleotide Polymorphisms ◽  
Genome Wide ◽  
History Of

Abstract Prior genome-wide association (GWA) studies have identified 10 susceptibility loci for risk of chronic lymphocytic leukemia (CLL). To identify additional loci, we performed a GWA study in 407 CLL cases (of which 102 had a family history of CLL) and 296 controls. Moreover, given the strong familial risk of CLL, we further subset our GWA analysis to the CLL cases with a family history of CLL to identify loci specific to these familial CLL cases. Our top hits from these analyses were evaluated in an additional sample of 252 familial CLL cases and 965 controls. Using all available data, we identified and confirmed an independent association of 4 single-nucleotide polymorphisms (SNPs) that met genome-wide statistical significance within the IRF8 (interferon regulatory factor 8) gene (combined P values ≤ 3.37 × 10−8), located in the previously identified 16q24.1 locus. Subsetting to familial CLL cases, we identified and confirmed a new locus on chromosome 6p21.3 (combined P value = 6.92 × 10−9). This novel region harbors the HLA-DQA1 and HLA-DRB5 genes. Finally, we evaluated the 10 previously reported SNPs in the overall sample and replicated 8 of them. Our findings support the hypothesis that familial CLL cases have additional genetic variants not seen in sporadic CLL. Additional loci among familial CLL cases may be identified through larger studies.

Human Papillomavirus and Pap Smear

2011 ◽  
Vol 6 (1) ◽  
pp. 31-44
Author(s):  
Indra Balachandran
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
High Risk ◽  
Pap Smear ◽  
Precancerous Lesions ◽  
The United States ◽  
Hpv Infection ◽  
Hpv Testing ◽  
Pap Smear Screening ◽  
High Risk Hpv

High-risk human papillomavirus (HPV) infection and viral persistence is a major risk factor in the development of squamous intraepithelial lesions and invasive carcinoma of the cervix. In the United States, deaths due to squamous cell carcinoma of the cervix have fallen by 75% since the 1960s because of Papanicolaou (Pap) smear screening. However, the traditional Pap had a sensitivity of about 70% for detecting clinically significant precancerous lesions and cancer because of sampling and interpretive errors. The introduction of 2 liquid-based Pap smear collection systems in the 1990s, the use of HPV testing as a triage and co-testing with Pap smear, and the introduction of 2 automated screening devices have had a significant impact on improving the detection of such precancerous lesions. This review provides an analysis of the changes in Pap smear collection, improvements in screening, the evolutionary changes of high-risk HPV testing, reporting terminology of Pap smears, and clinical management guidelines. The future impact of 2 prophylactic HPV vaccines on the incidence of cervical carcinoma is also discussed. This article also discusses alternatives such as primary screening for high-risk HPV testing with visual inspection for cervical cancer detection used in resource-poor settings with a high incidence of cervical cancer.

Sign in / Sign up

Export Citation Format

Share Document