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M94A2597.TXT
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1994-10-25
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Document 2597
DOCN M94A2597
TI Risk factors associated with the occurrence of squamous intra-epithelial
lesions (SIL) in HIV-infected women.
DT 9412
AU Heard I; Bergeron C; Henrion R; Kazatchkine M; Department of Obstetrics
and Gynecology, Maternite Port-Royal,; Paris, France.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):268 (abstract no. PB0500). Unique
Identifier : AIDSLINE ICA10/94369978
AB We have investigated cervical smears and factors associated with the
occurence os squamous intra-epithelial lesions (SIL) in a cohort of 110
HIV-infected women. Sixty-nine percent of the women were caucasians of
european origin. The route of contamination was sexual in 54% of the
women, IV drug injection in 23%, transfusion of contaminated blood in
9%, both sexual in association with IV drug addiction in 10%, and
unknown in 4%. The prevalence of SIL was 37.3% including low grade SIL
in 20% of the women (n = 22) and high grade SIL in 17.3% of the women (n
= 19). Biopsies performed under colposcopy in patients with SIL showed
no case of invasive cervical carcinoma. Only age at first sexual
intercourse and a previous history of pregnancy were associated with
SIL, among the risk factors for SIL that have been identified in general
population. No association was found with cigarette smoking, number of
life-time sexual partners, previous history of STD nor oral
contraception. The prevalence of SIL was 24% among women with CD4+ cell
counts above 200/mm3 and 61% among women with less than 200 CD4+
cells/mm3. The difference was significative (odds ratio, 0.20; 95%
confidence interval, 0.08 to 0.51). CD4 cell did not differ
significantly between IV drug users and sexually contaminated women. A
significantly higher prevalence of SIL was observed in IV drug users
(52%) than in sexually infected women (36%) (p = 0.0002). Late access to
medical care and IV drug-induced immune dysfunction may account for the
high prevalence of SIL among IV drug users. Our observations indicate
that the prevalence of SIL in HIV-infected women is determined by sexual
behavior and the degree of imunodeficiency. Early detection of SIL
should be improved by performing frequent smears in HIV-infected women
at high risk.
DE Carcinoma, Squamous Cell/*PATHOLOGY Cell Transformation,
Neoplastic/PATHOLOGY Cervix Neoplasms/*PATHOLOGY Cervix
Uteri/PATHOLOGY Female Human HIV Infections/*PATHOLOGY Neoplasm
Invasiveness Neoplasm Staging Precancerous Conditions/*PATHOLOGY Risk
Factors Vaginal Smears MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).