The risk of CIN and ICC was investigated longitudinally in 1232 H

The risk of CIN and ICC was investigated longitudinally in 1232 HIV-infected women aged 15 years and over, regardless of the route of infection, who were followed up between 1 January 1999 and 31 December 2006 at the Guadeloupian HIV Survey Health Centre. Each woman was resident

in Guadeloupe and provided written consent. Follow-up visits were scheduled at intervals of no more than 6 months, although the precise timing of these visits varied with the patient’s Erastin mouse immunological status. Cervical lesions (ICC or CIN) were diagnosed by histological procedures. We conducted a person-year analysis. Person-years at risk were calculated from the first visit to the date of death, the date of ICC or CIN diagnosis or the last follow-up visit, whichever occurred first. Women reporting a history of ICC at baseline or in whom ICC was diagnosed on evaluation at the entry visit were excluded from the study. The expected numbers of cases of ICC and CIN were calculated on the basis of ICC and CIN incidence rates for the period 1999 to 2006 in women aged 15 years and older for the general population of Guadeloupe. In the absence of a cancer

registry for Guadeloupe, incidence rates were calculated from data collected from all the pathology laboratories in the archipelago, as previously described [15]. Mean annual age-standardized ICC or CIN incidence rates were multiplied Ku-0059436 by the number of Dehydratase person-years of observation, to obtain the expected numbers of ICC and CIN, respectively. The observed number of cases was then

divided by the expected number, to obtain standardized incidence ratios (SIRs). Confidence intervals (CIs) were determined for these SIRs, assuming a Poisson distribution for the observed cases. In total, 7738 person-years of observation were accumulated during the study period for the population of HIV-infected women. Median age at inclusion was 37.2 (range 15 to 89) years. All HIV infections were caused by HIV-1. At inclusion, baseline CD4 cell count was ≥500 cells/μL in 31.4% of the women, 200–499 cells/μL in 43.6% of the women and <200 cells/μL in 25% of the women. Antiretroviral treatment was required in 78% of the women, and 63% of the women were treated with highly active antiretroviral therapy (HAART). The annual screening coverage rate for cervical cancer in women (Papanicolaou test) was 28%. The median duration of HIV disease since diagnosis was 6.8 years. Seventy-five cases of CIN (29 of CIN 1, 20 of CIN 2 and 26 of CIN 3) were diagnosed in HIV-infected women during the study period, whereas only 9.9 were expected (2.9 of CIN 1, 2.0 of CIN 2, and 5.0 of CIN 3) (Table 1). Thus, HIV-infected women had a significantly higher risk of CIN than women of the general population of Guadeloupe, taking all grades into account (SIR 7.6, 95% CI 6.0–9.5).

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