Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women

Linda Ahdieh-Grant, Rui Li, Alexandra M. Levine, L. Stewart Massad, Howard D. Strickler, Howard Minkoff, Michael Moxley, Joel Palefsky, Henry Sacks, Robert D. Burk, Stephen J Gange

Research output: Contribution to journalArticle

Abstract

Background: Women infected with human immunodeficiency virus (HIV) have an increased risk of persistent squamous intraepithelial lesions (SILs) of the cervix. We assessed the association between use of highly active antiretroviral therapy (HAART) and regression of SIL in HIV-infected women enrolled in the Women's Interagency HIV Study, a large, multicenter, prospective cohort study. Methods: Of 2059 HIV-infected participants, 312 HIV-infected women had normal cervical cytology at baseline and were subsequently diagnosed during 7 years of follow-up with incident SIL. Pap smears, CD4+ T-cell counts, and information regarding use of HAART were obtained every 6 months. The outcome of interest was lesion regression, defined as two consecutive normal Pap smears 6 months apart. Incidence rates of SIL regression were computed among person-years at risk, both before and after HAART initiation. All statistical tests were two-sided. Results: Of 312 women, 141 had lesions that regressed to normal cytology, with a median time to regression of 2.7 years. Overall, the incidence of regression increased (Ptrend = .002) over time after HAART was introduced. At incident SIL, median CD4+ T-cell counts were lower in women whose lesions did not regress than in women whose lesions regressed (230 versus 336 cells/μL; Ptrend = .002). Conclusions: HAART use was associated with increased regression of SIL among HIV-infected women, and among women who used HAART, increased CD4+ T-cell counts were associated with a greater likelihood of regression. However, the majority of cervical lesions among HIV-infected women, even among individuals who used HAART, did not regress to normal.

Original languageEnglish (US)
Pages (from-to)1070-1076
Number of pages7
JournalJournal of the National Cancer Institute
Volume96
Issue number14
StatePublished - Jul 21 2004

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Highly Active Antiretroviral Therapy
HIV
CD4 Lymphocyte Count
Papanicolaou Test
T-Lymphocytes
Cell Biology
Squamous Intraepithelial Lesions of the Cervix
Incidence
Cohort Studies
Prospective Studies

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women. / Ahdieh-Grant, Linda; Li, Rui; Levine, Alexandra M.; Massad, L. Stewart; Strickler, Howard D.; Minkoff, Howard; Moxley, Michael; Palefsky, Joel; Sacks, Henry; Burk, Robert D.; Gange, Stephen J.

In: Journal of the National Cancer Institute, Vol. 96, No. 14, 21.07.2004, p. 1070-1076.

Research output: Contribution to journalArticle

Ahdieh-Grant, L, Li, R, Levine, AM, Massad, LS, Strickler, HD, Minkoff, H, Moxley, M, Palefsky, J, Sacks, H, Burk, RD & Gange, SJ 2004, 'Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women', Journal of the National Cancer Institute, vol. 96, no. 14, pp. 1070-1076.
Ahdieh-Grant, Linda ; Li, Rui ; Levine, Alexandra M. ; Massad, L. Stewart ; Strickler, Howard D. ; Minkoff, Howard ; Moxley, Michael ; Palefsky, Joel ; Sacks, Henry ; Burk, Robert D. ; Gange, Stephen J. / Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women. In: Journal of the National Cancer Institute. 2004 ; Vol. 96, No. 14. pp. 1070-1076.
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abstract = "Background: Women infected with human immunodeficiency virus (HIV) have an increased risk of persistent squamous intraepithelial lesions (SILs) of the cervix. We assessed the association between use of highly active antiretroviral therapy (HAART) and regression of SIL in HIV-infected women enrolled in the Women's Interagency HIV Study, a large, multicenter, prospective cohort study. Methods: Of 2059 HIV-infected participants, 312 HIV-infected women had normal cervical cytology at baseline and were subsequently diagnosed during 7 years of follow-up with incident SIL. Pap smears, CD4+ T-cell counts, and information regarding use of HAART were obtained every 6 months. The outcome of interest was lesion regression, defined as two consecutive normal Pap smears 6 months apart. Incidence rates of SIL regression were computed among person-years at risk, both before and after HAART initiation. All statistical tests were two-sided. Results: Of 312 women, 141 had lesions that regressed to normal cytology, with a median time to regression of 2.7 years. Overall, the incidence of regression increased (Ptrend = .002) over time after HAART was introduced. At incident SIL, median CD4+ T-cell counts were lower in women whose lesions did not regress than in women whose lesions regressed (230 versus 336 cells/μL; Ptrend = .002). Conclusions: HAART use was associated with increased regression of SIL among HIV-infected women, and among women who used HAART, increased CD4+ T-cell counts were associated with a greater likelihood of regression. However, the majority of cervical lesions among HIV-infected women, even among individuals who used HAART, did not regress to normal.",
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T1 - Highly active antiretroviral therapy and cervical squamous intraepithelial lesions in human immunodeficiency virus-positive women

AU - Ahdieh-Grant, Linda

AU - Li, Rui

AU - Levine, Alexandra M.

AU - Massad, L. Stewart

AU - Strickler, Howard D.

AU - Minkoff, Howard

AU - Moxley, Michael

AU - Palefsky, Joel

AU - Sacks, Henry

AU - Burk, Robert D.

AU - Gange, Stephen J

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Y1 - 2004/7/21

N2 - Background: Women infected with human immunodeficiency virus (HIV) have an increased risk of persistent squamous intraepithelial lesions (SILs) of the cervix. We assessed the association between use of highly active antiretroviral therapy (HAART) and regression of SIL in HIV-infected women enrolled in the Women's Interagency HIV Study, a large, multicenter, prospective cohort study. Methods: Of 2059 HIV-infected participants, 312 HIV-infected women had normal cervical cytology at baseline and were subsequently diagnosed during 7 years of follow-up with incident SIL. Pap smears, CD4+ T-cell counts, and information regarding use of HAART were obtained every 6 months. The outcome of interest was lesion regression, defined as two consecutive normal Pap smears 6 months apart. Incidence rates of SIL regression were computed among person-years at risk, both before and after HAART initiation. All statistical tests were two-sided. Results: Of 312 women, 141 had lesions that regressed to normal cytology, with a median time to regression of 2.7 years. Overall, the incidence of regression increased (Ptrend = .002) over time after HAART was introduced. At incident SIL, median CD4+ T-cell counts were lower in women whose lesions did not regress than in women whose lesions regressed (230 versus 336 cells/μL; Ptrend = .002). Conclusions: HAART use was associated with increased regression of SIL among HIV-infected women, and among women who used HAART, increased CD4+ T-cell counts were associated with a greater likelihood of regression. However, the majority of cervical lesions among HIV-infected women, even among individuals who used HAART, did not regress to normal.

AB - Background: Women infected with human immunodeficiency virus (HIV) have an increased risk of persistent squamous intraepithelial lesions (SILs) of the cervix. We assessed the association between use of highly active antiretroviral therapy (HAART) and regression of SIL in HIV-infected women enrolled in the Women's Interagency HIV Study, a large, multicenter, prospective cohort study. Methods: Of 2059 HIV-infected participants, 312 HIV-infected women had normal cervical cytology at baseline and were subsequently diagnosed during 7 years of follow-up with incident SIL. Pap smears, CD4+ T-cell counts, and information regarding use of HAART were obtained every 6 months. The outcome of interest was lesion regression, defined as two consecutive normal Pap smears 6 months apart. Incidence rates of SIL regression were computed among person-years at risk, both before and after HAART initiation. All statistical tests were two-sided. Results: Of 312 women, 141 had lesions that regressed to normal cytology, with a median time to regression of 2.7 years. Overall, the incidence of regression increased (Ptrend = .002) over time after HAART was introduced. At incident SIL, median CD4+ T-cell counts were lower in women whose lesions did not regress than in women whose lesions regressed (230 versus 336 cells/μL; Ptrend = .002). Conclusions: HAART use was associated with increased regression of SIL among HIV-infected women, and among women who used HAART, increased CD4+ T-cell counts were associated with a greater likelihood of regression. However, the majority of cervical lesions among HIV-infected women, even among individuals who used HAART, did not regress to normal.

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JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

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