HIV and Cervical Cancer Risk in South Africa
Author Information
Author(s): Moodley Jennifer R, Hoffman Margaret, Carrara Henri, Allan Bruce R, Cooper Diane D, Rosenberg Lynn, Denny Lynette E, Shapiro Samuel, Williamson Anna-Lise
Primary Institution: University of Cape Town
Hypothesis
What is the risk of cervical pre-cancer and cancer among HIV positive women in South Africa?
Conclusion
HIV positive women were at an increased risk of cervical pre-cancer, but did not demonstrate an excess risk of invasive cervical cancer.
Supporting Evidence
- HIV positive women were nearly 5 times more likely to have high-risk HPV compared to HIV negative women.
- The study found a significant association between HIV and cervical SILs.
- Women infected with both HIV and high-risk HPV had a more than 40-fold higher risk of SIL.
Takeaway
Women with HIV are more likely to have early signs of cervical cancer, but not necessarily the full-blown disease.
Methodology
A case-control study was conducted with 524 cases of cervical cancer and 1541 controls, examining the association between HIV and cervical lesions.
Potential Biases
Potential for misclassification of cytological results, though it was minimized by blinding.
Limitations
Cytological abnormalities were not histologically confirmed, and immune status was not recorded.
Participant Demographics
Cases were primarily Coloured and Black women with first occurrences of invasive cervical cancer.
Statistical Information
P-Value
0.004
Confidence Interval
95% CI (2.3 – 8.4) for ASCUS, 95% CI (3.5 – 15.7) for LSIL, 95% CI (2.4 – 13.6) for HSIL, 95% CI (0.75 – 1.85) for invasive cervical cancer.
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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