Cervical intraepithelial neoplasia and invasive cancer risks in women infected with HIV in the French West Indies

Authors

  • P Kadhel,

    1. Parent-Child Department, Gynecology and Obstetrics Unit, Pointe-à-Pitre/Abymes University Hospital Center, Pointe-à-Pitre Cedex, France
    2. French National Institute of Health and Medical Research (Inserm) U625, College of Medicine, Campus of Fouillole, Pointe-à-Pitre Cedex, France
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  • L Multigner,

    1. French National Institute of Health and Medical Research (Inserm) U625, College of Medicine, Campus of Fouillole, Pointe-à-Pitre Cedex, France
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  • F Bardinet,

    1. Parent-Child Department, Gynecology and Obstetrics Unit, Pointe-à-Pitre/Abymes University Hospital Center, Pointe-à-Pitre Cedex, France
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  • MT Goerger-Sow,

    1. Regional Coordination of the Fight Against HIV Infection in Guadeloupe (COREVIH), Pointe-à-Pitre/Abymes University Hospital Center, Pointe-à-Pitre Cedex, France
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  • E Janky

    1. Parent-Child Department, Gynecology and Obstetrics Unit, Pointe-à-Pitre/Abymes University Hospital Center, Pointe-à-Pitre Cedex, France
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Dr Philippe Kadhel, Parent-Child Department, Gynecology and Obstetrics Unit, Pointe-à-Pitre/Abymes University Hospital Center, Route de Chauvel, 97159 Pointe-à-Pitre Cedex, France. Tel/fax: +590 590 891 387; e-mail: philippe.kadhel@orange.fr

Abstract

Objective

The aim of the study was to assess whether HIV infection is associated with a higher risk of invasive cervical cancer (ICC).

Methods

We conducted a region-wide, population-based observational cohort study of 1232 HIV-infected women over the age of 15 years in Guadeloupe, a French Caribbean archipelago, during the period 1999–2006. The observed numbers of incident cases of cervical intraepithelial neoplasia (CIN) and ICC were compared with the expected numbers of cases based on the incidence rates for the general population, and the standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated.

Results

The incidence rate of CIN was higher in the HIV-infected women than in the general population for all grades (SIR 10.1, 95% CI 6.8–14.6 for CIN grade 1; SIR 9.9, 95% CI 6.1–15.3 for CIN grade 2; and SIR 5.2, 95% CI 3.4–7.7 for CIN grade 3). However, no increase in the risk of ICC was observed (SIR 1.7, 95% CI 0.3–4.9).

Conclusions

Despite an increase in the occurrence of cervical cancer precursors, no increase in the risk of cervical cancer was found in a population of HIV-infected women who receive treatment for their infection and have access to ICC prevention services.

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