Blog
About

  • Record: found
  • Abstract: found
  • Article: found
Is Open Access

Pap testing among newly diagnosed women living with HIV/AIDS (WLWHA) in South Carolina (SC): routine screening and abnormal follow-up behaviors of HIV-positive female SC medicaid recipients 18-64 years between 2005-2009

, 1 , 1 , 2 , 3 , 4 , 5 , 6 , 1 , 1

Infectious Agents and Cancer

BioMed Central

13th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI)

7-8 November 2011

Read this article at

Bookmark
      There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

      Related collections

      Most cited references 4

      • Record: found
      • Abstract: found
      • Article: not found

      Risk of human papillomavirus-associated cancers among persons with AIDS.

      Although risk of human papillomavirus (HPV)-associated cancers of the anus, cervix, oropharynx, penis, vagina, and vulva is increased among persons with AIDS, the etiologic role of immunosuppression is unclear and incidence trends for these cancers over time, particularly after the introduction of highly active antiretroviral therapy in 1996, are not well described. Data on 499 230 individuals diagnosed with AIDS from January 1, 1980, through December 31, 2004, were linked with cancer registries in 15 US regions. Risk of in situ and invasive HPV-associated cancers, compared with that in the general population, was measured by use of standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). We evaluated the relationship of immunosuppression with incidence during the period of 4-60 months after AIDS onset by use of CD4 T-cell counts measured at AIDS onset. Incidence during the 4-60 months after AIDS onset was compared across three periods (1980-1989, 1990-1995, and 1996-2004). All statistical tests were two-sided. Among persons with AIDS, we observed statistically significantly elevated risk of all HPV-associated in situ (SIRs ranged from 8.9, 95% CI = 8.0 to 9.9, for cervical cancer to 68.6, 95% CI = 59.7 to 78.4, for anal cancer among men) and invasive (SIRs ranged from 1.6, 95% CI = 1.2 to 2.1, for oropharyngeal cancer to 34.6, 95% CI = 30.8 to 38.8, for anal cancer among men) cancers. During 1996-2004, low CD4 T-cell count was associated with statistically significantly increased risk of invasive anal cancer among men (relative risk [RR] per decline of 100 CD4 T cells per cubic millimeter = 1.34, 95% CI = 1.08 to 1.66, P = .006) and non-statistically significantly increased risk of in situ vagina or vulva cancer (RR = 1.52, 95% CI = 0.99 to 2.35, P = .055) and of invasive cervical cancer (RR = 1.32, 95% CI = 0.96 to 1.80, P = .077). Among men, incidence (per 100 000 person-years) of in situ and invasive anal cancer was statistically significantly higher during 1996-2004 than during 1990-1995 (61% increase for in situ cancers, 18.3 cases vs 29.5 cases, respectively; RR = 1.71, 95% CI = 1.24 to 2.35, P < .001; and 104% increase for invasive cancers, 20.7 cases vs 42.3 cases, respectively; RR = 2.03, 95% CI = 1.54 to 2.68, P < .001). Incidence of other cancers was stable over time. Risk of HPV-associated cancers was elevated among persons with AIDS and increased with increasing immunosuppression. The increasing incidence for anal cancer during 1996-2004 indicates that prolonged survival may be associated with increased risk of certain HPV-associated cancers.
        Bookmark
        • Record: found
        • Abstract: found
        • Article: not found

        Human papillomavirus-related disease in people with HIV.

         Joel Palefsky (2008)
        The incidence of human papillomavirus (HPV)-related cancers has increased among people with HIV infection compared with the general population. This review will describe recent findings in HPV-associated cancer incidence since the introduction of antiretroviral therapy, HPV/disease prevalence at sites other than cervix and anus, and recent data on screening and treatment of anal intraepithelial neoplasia. Consistent with high prevalence of anogenital HPV infection, new data on cervical intraepithelial neoplasia and anal intraepithelial neoplasia in HIV-positive men and women show that the incidence of cervical cancer has not declined since the introduction of antiretroviral therapy and that the incidence of anal cancer is rising. Several studies also highlight high rates of HPV infection and HPV-associated disease at sites other than the cervix and anus, including the penis and the mouth. Treatment methods for anal intraepithelial neoplasia have been described and show reasonable efficacy. New data imply that the problem of HPV-related cancers will not decline among HIV-positive men and women in the antiretroviral therapy era, highlighting the need to perform studies to determine if screening and treatment of anal intraepithelial neoplasia will prevent development of anal cancer. Recent data show progress in both these areas.
          Bookmark
          • Record: found
          • Abstract: found
          • Article: not found

          Prevention of cervical cancer in women with HIV.

          Cervical cancer, caused by the human papillomavirus (HPV), is the only cancer that is almost preventable through regular screening. In high-resource, as in low-resource and middle-resource countries, women hit by the AIDS epidemic have a high prevalence of infection with HPV and related disease, including cervical cancer. The question whether cervical screening, which helped to reduce dramatically cervical cancer rates through the detection of precancerous lesions in the general population, is as efficient in the setting of HIV is still debated. The risk for cervical cancer remained high and stable during the last decade in HIV-infected women, and incidence did not decrease with improving CD4 cell counts in women receiving antiviral therapy. Optimal methods to improve both the sensitivity and the specificity of cervical cancer screening are currently evaluated. The use of HPV DNA tests in primary screening endorsed in the general population may be less specific in immunocompromised women and might thus not be as efficient on screening. HPV vaccines, recently available, have no therapeutic effect and might thus not be very useful in preventing cervical cancer in a population highly infected with multiple and persistent HPV. Cervical cancer prevention remains an important goal in HIV-infected women and specific guidelines are warranted for this increasing population.
            Bookmark

            Author and article information

            Affiliations
            [1 ]University of South Carolina (USC) – Arnold School of Public Health, (a) Department of Health Services, Policy and Management, (b) Department of Health Promotion, Education, and Behavior, (c) Department of Epidemiology and Biostatistics, Columbia, SC, USA
            [2 ]University of South Carolina – School of Medicine, Division of Infectious Diseases, Columbia, SC, USA
            [3 ]South Carolina Department of Health and Environmental Control (SCDHEC), HIV/STD Division, Columbia, SC, USA
            [4 ]Medical University of South Carolina – College of Nursing, Charleston, SC, USA
            [5 ]University of Maryland – School of Public Health, College Park, MD, USA
            [6 ]South Carolina State Budget and Control Board, Office of Research and Statistics, Columbia, SC, USA
            Contributors
            Conference
            Infect Agent Cancer
            Infect. Agents Cancer
            Infectious Agents and Cancer
            BioMed Central
            1750-9378
            2012
            19 April 2012
            : 7
            : Suppl 1
            : P18
            3330061
            1750-9378-7-S1-P18
            10.1186/1750-9378-7-S1-P18
            Copyright ©2012 Wigfall et al; licensee BioMed Central Ltd.

            This is an open access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

            13th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI)
            Bethesda, MD, USA
            7-8 November 2011
            Categories
            Poster Presentation

            Oncology & Radiotherapy

            Comments

            Comment on this article