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

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