AEGiS-13IAC: Case-control study of cervical cancer and HIV infection in Abidjan, Cote D'Ivoire.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Case-control study of cervical cancer and HIV infection in Abidjan, Cote D'Ivoire.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrB233)

Boni-Ouattara E, Adjorlolo-Johnson G, Anhoux A, Toure-Coulibaly K, Kone M, Unger E, Honde M, Vernon S, Greenberg A
E. Boni-Ouattara, Project Retro-CI, 01 BP 1712, Abidjan, Cote D'ivoire, Tel.: +225 212 541 11, Fax: +225 212 429 69, E-mail: ehb8@cdc.gov

OBJECTIVES: To evaluate the association between HIV infection and cervical cancer and to compare characteristics of HIV-infected and uninfected women with cervical cancer.

METHODS: From 4/1997 to 10/1999, consenting women presenting with cervical lesions at the gynecology and oncology services of two university hospitals in Abidjan were interviewed, a blood sample was collected, and cervical biopsy was performed. Women with histologically-confirmed cervical cancer were retained as cases. Consenting women attending the same clinics for non-gynecological reasons were also interviewed, underwent blood drawing and cervical cytologic examination. Those with normal cervical cytology were retained as controls.

RESULTS: 102 women with cervical cancer and 102 controls were enrolled. Sixteen case-women (15.7%; 12 HIV-1, 3 HIV-2, 1 HIV-1/2 dually reactive) and eight controls (7.8%; HIV-1, 1 HIV-1/2 dually-reactive) were HIV infected. Among women aged >40 years, HIV-1 infection was more common (30.8%) among case-women than among controls (10.6%) (odds ratio [OR] 3.7, 95% confidence interval [CI] 0.9-15.7). Among women aged é 40 years, HIV-1 prevalence was 5.6% in case-women and 3.7% in controls (OR 1.5, CI 0.2-12.7). In separate logistic regression models, for women aged >40 years, only HIV-1 infection was associated with cervical cancer (OR 4.6, CI 1.1-19.9); while among women aged é 40 years significant associations were found for parity >2 (OR 4.8, CI 1.4-16.1), positive syphilis serology (OR 3.5, CI 1.5-8.6), and lower quality housing (OR 2.6, CI 1.1-6.0), but not for HIV-1 infection (OR1.1, CI 0.2-7.6). Among case-women, median age was lower for HIV-1 infected (37 years) than HIV-1-uninfected women (48 years, p = 0.0001). 50% of HIV-1-positive women had clinical stage III or IV cervical cancer compared with 49% of HIV-negative women. Only 16% of controls had a past history of cervical cancer screening.

CONCLUSIONS: In younger women in Abidjan, HIV appears to be a risk factor for cervical cancer. In settings of high HIV prevalence, it is particularly important to make cervical cancer screening readily available.

Keywords: AEGIS, HIV Infections, Cervix Neoplasms, HIV-1, Case-Control Studies, Prevalence, Risk Factors, HIV Seropositivity, HIV, HIV-2, Cervix Diseases, Cervix Uteri, Vaginal Smears, Odds Ratio, Cote d'Ivoire, Human, Female
000709
MoOrB233