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Abstract
ABSTRACT
INTRODUCTION. Many studies have showed a high risk of HPV persistence and the development of cervical cancer among immuno deficient patients. In the aim to determine serotypes of human papilloma virus (HPV) of high risk among HIV infected women with cervical intra epithelial lesions, we conducted a prospective and analytic the study at Medical Diagnostic center and in Centre Pasteur of Yaoundé.
METHODOLOGY. We carried out a prospective and analytic study which took 9 months. The study included 112 HIV sexually active infected women. Data of interest were the type of cervical epithelial lesions lesion and its grade and risk factors.
RESULTS. The average age was 38,5 years. 66% of the smear tests were inflammatory and 21% were dysplastic.
71% of the dysplastic lesions were of high grade. In this high grade group, the HPV testing was always negative. The only significant risk factor was the low CD4 count.
CONCLUSION. In Cameroonian HIV infected women, high grade intra epithelial lesions are associated with HPV serotypes that are not highly aggressive, and that therefore can be missed by the ABOOT test.
RÉSUMÉ
INTRODUCTION. De nombreuses études ont montre un risque élevé de persistance du HPV et de développement du cancer du col chez les patientes immunodéprimées
Dans le but de déterminer les Serotypes HPV a haut risque parmi les femmes séropositives au HIV ayant des lésions intra épithéliales, nous avons entrepris une étude prospective et analytique au laboratoire Médical center et au Centre Pasteur de Yaoundé.
MÉTHODOLOGIE. Il s`agit d`une étude prospective et analytique qui s`est étalée sur 9 mois. Nous avons inclus 112 patientes séropositives, actives sexuellement. Les variables étudiées étaient le type de lésion et le grade ainsi que les facteurs de risques.
RÉSULTATS. L`âge moyen des patientes était de 38,5 ans. 66% des frottis étaient inflammatoires ( 66%) et 21% étaient dysplasiques. Chez les 21 patientes ayant une dysplasie cervicale, 15 (71%) présentaient une dysplasie de haut grade H-SIL. Dans ce groupe, le test HPV a été constamment négatif, et le seul facteur de risque significatif était le taux bas de CD4.
CONCLUSION. Chez les patientes HIV positives, les lésions de haut grade sont dues à des Serotypes HPV peu agressifs, donc non visualises par le test ABOOTT qui ne détecte que les Serotypes a haut risque.
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References
- -Nicolas Duport: données épidémiologiques sur le cancer du col de l`uterus-Etat des connaissances-Actualisation 2008;Institut de veille sanitaire
- -Liaw KL HA.A prospective study of human papilloma virus(HPV) type 16 DNA polymerase chain reaction and its association with acquisition and persistence of other HPV types; J infect Dis 2001;185-
- -Six C, Heard, Bergeron C, Orth G, Povera JD et al. comparative prevalence, incidence, and short term prognosis of cervical squamous intra epithelial lesions among HIV positive and HIV negative women. Aids lond engl 1998; 12(9) 1047-56
- -National institute statistics (NIS) and ORC Macro. Cameroon demographic and Health survey (2004) Calverton Maryland USA: NIS and ORC Macro
- -Atashili J, Adimora AA, Ndumbe PM, Ikomey GM, Rinas AC, Myers E, et al. High prevalence of cervical squamous intraepithelial lesions in women on antiretroviral therapy in Cameroon: is targeted screening feasible? Cancer Epidemiol. 2012; 36(3):263-9.
- -Suhasini M, Reddy T R. Cellular Proteins and HIV-1 Rev Function. Current HIV Research. 2009;7 (1), 91-100 91
- -Nkegoum B, Belley priso, Mbakop, Gwet Bell E ;Lésions précancéreuses du col utérin chez la femme camerounaise; aspects cytologiques et épidémiologiques de 946 cas :Gynécologie Obstétrique et fertilité 2001 ;29(1) 15-20
- -Tebeu PM, Sando Z, Sama DA. Prevalence and Geographical Distribution of Precancerous Lesions of the Uterine Cervix in Cameroon. Journal of cytology histology. 2013.
- -Firnhaber C, Van Le H, Pettifor A, Schulze D, Michelow P, Sanne IM, et al. Association between cervical dysplasia and human papillomavirus in HIV seropositive women from Johannesburg South Africa. Cancer Causes Control CCC. 2010; 21(3):433-43.
- -Anorlu R I, Adult Karem T B,Abudu OO, Oyekan TO: Cervical cytology in urban population in Lagos; Nigeria Journal of Obstetrics and Gynecology 2003 Vol 23;No 3 P285-288
- -Mogtomo ml, Malieugoue Il, Djiepgang c, Wankam m, Moune a, Ngane an: incidence of cervical disease associated to HPV in human immunodeficiency infected women under highly active antiretroviral therapy. Infect agent cancer 2009;4:9
- -Zhang HY, Tiggelaar SM, Sahasrabuddhe VV, Smith JS, Jiang CQ, Mei RB et al. HPV prevalence and cervical intraepithelial neoplasia among HIV-infected women in Yunnan province, China: a pilot study. Asian Pacific J Cancer Prev, 2012;13, 91-96.
References
-Nicolas Duport: données épidémiologiques sur le cancer du col de l`uterus-Etat des connaissances-Actualisation 2008;Institut de veille sanitaire
-Liaw KL HA.A prospective study of human papilloma virus(HPV) type 16 DNA polymerase chain reaction and its association with acquisition and persistence of other HPV types; J infect Dis 2001;185-
-Six C, Heard, Bergeron C, Orth G, Povera JD et al. comparative prevalence, incidence, and short term prognosis of cervical squamous intra epithelial lesions among HIV positive and HIV negative women. Aids lond engl 1998; 12(9) 1047-56
-National institute statistics (NIS) and ORC Macro. Cameroon demographic and Health survey (2004) Calverton Maryland USA: NIS and ORC Macro
-Atashili J, Adimora AA, Ndumbe PM, Ikomey GM, Rinas AC, Myers E, et al. High prevalence of cervical squamous intraepithelial lesions in women on antiretroviral therapy in Cameroon: is targeted screening feasible? Cancer Epidemiol. 2012; 36(3):263-9.
-Suhasini M, Reddy T R. Cellular Proteins and HIV-1 Rev Function. Current HIV Research. 2009;7 (1), 91-100 91
-Nkegoum B, Belley priso, Mbakop, Gwet Bell E ;Lésions précancéreuses du col utérin chez la femme camerounaise; aspects cytologiques et épidémiologiques de 946 cas :Gynécologie Obstétrique et fertilité 2001 ;29(1) 15-20
-Tebeu PM, Sando Z, Sama DA. Prevalence and Geographical Distribution of Precancerous Lesions of the Uterine Cervix in Cameroon. Journal of cytology histology. 2013.
-Firnhaber C, Van Le H, Pettifor A, Schulze D, Michelow P, Sanne IM, et al. Association between cervical dysplasia and human papillomavirus in HIV seropositive women from Johannesburg South Africa. Cancer Causes Control CCC. 2010; 21(3):433-43.
-Anorlu R I, Adult Karem T B,Abudu OO, Oyekan TO: Cervical cytology in urban population in Lagos; Nigeria Journal of Obstetrics and Gynecology 2003 Vol 23;No 3 P285-288
-Mogtomo ml, Malieugoue Il, Djiepgang c, Wankam m, Moune a, Ngane an: incidence of cervical disease associated to HPV in human immunodeficiency infected women under highly active antiretroviral therapy. Infect agent cancer 2009;4:9
-Zhang HY, Tiggelaar SM, Sahasrabuddhe VV, Smith JS, Jiang CQ, Mei RB et al. HPV prevalence and cervical intraepithelial neoplasia among HIV-infected women in Yunnan province, China: a pilot study. Asian Pacific J Cancer Prev, 2012;13, 91-96.