Lars Jørgen Østergaard

Risk factors for cervical intraepithelial neoplasia in HIV-infected women on antiretroviral treatment in Côte d'Ivoire, West Africa

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Antoine Jaquet
  • ,
  • Apollinaire Horo
  • ,
  • Didier K Ekouevi
  • ,
  • Badian Toure, Unknown
  • Patrick A Coffie
  • ,
  • Benjamin Effi, Unknown
  • Severin Lenaud
  • ,
  • Eugene Messou
  • ,
  • Albert Minga
  • ,
  • Annie J Sasco, Unknown
  • François Dabis
  • ,
  • IeDEA West Africa Collaboration (Lars Østergaard, Christian Wejse members)

BACKGROUND: Facing the dual burden of invasive cervical cancer and HIV in sub-Saharan Africa, the identification of preventable determinants of Cervical Intraepithelial Neoplasia (CIN) in HIV-infected women is of paramount importance.

METHODS: A cervical cancer screening based on visual inspection methods was proposed to HIV-infected women in care in Abidjan, Côte d'Ivoire. Positively screened women were referred for a colposcopy to a gynaecologist who performed directed biopsies.

RESULTS: Of the 2,998 HIV-infected women enrolled, 132 (4.4%) CIN of any grade (CIN+) were identified. Women had been followed-up for a median duration of three years [IQR: 1-5] and 76% were on antiretroviral treatment (ART). Their median most recent CD4 count was 452 [IQR: 301-621] cells/mm3. In multivariate analysis, CIN+ was associated with a most recent CD4 count >350 cells/mm3 (OR: 0.3; 95% CI: 0.2-0.6) or ≥200-350 cells/mm3 (OR 0.6; 95% CI 0.4-1.0) (Ref: <200 cells/mm3 CD4) (p<10-4).

CONCLUSIONS: The presence of CIN+ is less common among HIV-infected women with limited or no immune deficiency. Despite the potential impact of immunological recovery on the reduction of premalignant cervical lesions through the use of ART, cervical cancer prevention, including screening and vaccination remains a priority in West Africa while ART is rolled-out.

Original languageEnglish
JournalPLOS ONE
Volume9
Issue3
Pages (from-to)e90625
ISSN1932-6203
DOIs
Publication statusPublished - 2014

    Research areas

  • Adult, Anti-Retroviral Agents, CD4 Lymphocyte Count, Cervical Intraepithelial Neoplasia, Cervix Uteri, Colposcopy, Cote d'Ivoire, Female, HIV, HIV Infections, Humans, Middle Aged, Risk Factors, Uterine Cervical Neoplasms

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