Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Evolution of cervical abnormalities among women with HIV-1: Evidence from surveillance cytology in the women's interagency HIV study
Autore:
Massad, LS; Ahdieh, L; Benning, L; Minkoff, H; Greenblatt, RM; Watts, H; Miotti, P; Anastos, K; Moxley, M; Muderspach, LI; Melnick, S;
Indirizzi:
Cook Cty Hosp, Dept Obstet & Gynecol, Div Gynecol Oncol, Chicago, IL 60612USA Cook Cty Hosp Chicago IL USA 60612 iv Gynecol Oncol, Chicago, IL 60612USA Rush Med Coll, Chicago, IL 60612 USA Rush Med Coll Chicago IL USA 60612Rush Med Coll, Chicago, IL 60612 USA Johns Hopkins Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA Johns Hopkins Sch Publ Hlth Baltimore MD USA pidemiol, Baltimore, MD USA Maimonides Hosp, Dept Obstet & Gynecol, Brooklyn, NY 11219 USA Maimonides Hosp Brooklyn NY USA 11219 t & Gynecol, Brooklyn, NY 11219 USA Univ Calif San Francisco, Dept Med, San Francisco, CA 94143 USA Univ CalifSan Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA 94143 USA UnivCalif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Natl Inst Child Hlth, Bethesda, MD USA Natl Inst Child Hlth Bethesda MD USA l Inst Child Hlth, Bethesda, MD USA NIAID, Bethesda, MD 20892 USA NIAID Bethesda MD USA 20892NIAID, Bethesda, MD 20892 USA Catholic Med Ctr Brooklyn, Jamaica, NY USA Catholic Med Ctr Brooklyn Jamaica NY USA d Ctr Brooklyn, Jamaica, NY USA Catholic Med Ctr Queens, Jamaica, NY USA Catholic Med Ctr Queens Jamaica NY USA c Med Ctr Queens, Jamaica, NY USA Georgetown Univ, Med Ctr, Washington, DC 20007 USA Georgetown Univ Washington DC USA 20007 Med Ctr, Washington, DC 20007 USA Univ So Calif, Sch Med, Dept Obstet & Gynecol, Los Angeles, CA 90033 USA Univ So Calif Los Angeles CA USA 90033 Gynecol, Los Angeles, CA 90033 USA NCI, Bethesda, MD 20892 USA NCI Bethesda MD USA 20892NCI, Bethesda, MD 20892 USA
Titolo Testata:
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
fascicolo: 5, volume: 27, anno: 2001,
pagine: 432 - 442
SICI:
1525-4135(20010815)27:5<432:EOCAAW>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; SQUAMOUS INTRAEPITHELIAL LESIONS; PAPANICOLAOU SMEARS; SEROPOSITIVE WOMEN; INFECTED WOMEN; RISK-FACTORS; NEOPLASIA; PREVALENCE; IMMUNOSUPPRESSION; COLPOSCOPY;
Keywords:
HIV; papanicolaou smear; cervix;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Massad, LS Cook Cty Hosp, Dept Obstet & Gynecol, Div Gynecol Oncol, 1835 WHarrison St, Chicago, IL 60612 USA Cook Cty Hosp 1835 W Harrison St Chicago IL USA 60612 60612 USA
Citazione:
L.S. Massad et al., "Evolution of cervical abnormalities among women with HIV-1: Evidence from surveillance cytology in the women's interagency HIV study", J ACQ IMM D, 27(5), 2001, pp. 432-442

Abstract

Objective: To determine incidence, progression, and regression rates for abnormal cervical cytology and their correlates among women with HIV. Methods: In a multicenter prospective cohort study conducted October 1, 1994, through September 30, 1999 at university, public, and private medical centers and clinics, 1639 HIV-seropositive and 452 seronegative women were evaluated every 6 months for up to 5 years using history, cervical cytology,T-cell subsets, and quantitative plasma HIV RNA. Human papillomavirus (HPV) typing at baseline was determined by polymerase chain reaction. Cytology was read using the Bethesda system, with any smear showing at least atypia considered abnormal. Poisson regression identified factors associated with incident cytologic abnormalities whereas logistic regression identified those associated with progression and regression after an abnormality. Results: At least one abnormal smear was found during all of follow-up among 73.0% of HIV-seropositive patients and 42.3% of seronegatives (p < .001). Only 5.9% of seropositives ever developed high-grade lesions, and the proportion with high-grade findings did not rise over time. Incidence of atypical squamous cells of uncertain significance (ASCUS) or more severe lesionsamong HIV-seropositive patients and seronegative patients was 26.4 and 11.0/100 woman-years (rate ratio [RR], 2.4; 95% confidence interval [CI], 1.9-3.0), whereas that of at least low-grade squamous intraepithelial lesions (SIL) was 8.9 and 2.2/100 (RR, 4.0; Cl, 2.6-6.1). HIV status, detection of the presence of human papillomavirus (HPV), CD4 lymphocyte count, and HIV RNA level predicted incidence of abnormal cytology (p < .05); HPV detection and HIV RNA level predicted progression (p < .01); and HPV detection, CD4 lymphocyte count, and HIV RNA level predicted regression (p < 00.1). Rates ofincidence, progression, and regression of abnormal cytology did not differbetween HIV seronegative women and seropositive women with CD4 lymphocyte counts > 200/mm(3) and HIV RNA levels < 4000/ml of similar HPV status. Conclusions: Although HIV infected women were at high risk for abnormal cytology, high-grade changes were uncommon. HIV status, HPV detection, CD4 lymphocyte count, and HIV RNA level predicted the incidence of cervical cytologic abnormalities. Progression was significantly increased only among the most immunosuppressed women, while regression was significantly reduced in all HIV seropositive women except those with the best controlled HIV disease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/01/20 alle ore 14:53:07