60941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virus
ABSTRACT IMPACT: The potential to use vaginal pH as a low cost, non-invasive diagnostic test at the point of CIN2 diagnosis to predict worsening of cervical disease. OBJECTIVES/GOALS: We previously reported that persistence/progression of cervical intraepithelial neoplasia-2 (CIN2) was uncommon in w...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2021-03-01
|
| Series: | Journal of Clinical and Translational Science |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866121004659/type/journal_article |
| _version_ | 1827993791305351168 |
|---|---|
| author | Katherine Michel Christine Colie Robert D. Burk L. Stewart Massad Cuiwei Wang Michaeline Hebron Charbel Moussa Gypsyamber D’Souza Lisa Rahangdale Lisa Flowers Joel Milam Joel M. Palefsky Howard Minkoff Howard D. Strickler Seble G. Kassaye |
| author_facet | Katherine Michel Christine Colie Robert D. Burk L. Stewart Massad Cuiwei Wang Michaeline Hebron Charbel Moussa Gypsyamber D’Souza Lisa Rahangdale Lisa Flowers Joel Milam Joel M. Palefsky Howard Minkoff Howard D. Strickler Seble G. Kassaye |
| author_sort | Katherine Michel |
| collection | DOAJ |
| description | ABSTRACT IMPACT: The potential to use vaginal pH as a low cost, non-invasive diagnostic test at the point of CIN2 diagnosis to predict worsening of cervical disease. OBJECTIVES/GOALS: We previously reported that persistence/progression of cervical intraepithelial neoplasia-2 (CIN2) was uncommon in women living with HIV (WLH) from the Women’s Interagency HIV Study (WIHS, now MWCCS). Here we examined additional factors that may influence CIN2 natural history. METHODS/STUDY POPULATION: A total of 337 samples from 94 WLH with a confirmed CIN2 diagnosis were obtained from the MWCCS. 42 cervicovaginal HPV types and 34 cervicovaginal cytokines/chemokines were measured at CIN2 diagnosis (94 samples) and 6-12 months prior to CIN2 diagnosis (79 samples). Covariates, including CD4 count and vaginal pH, were abstracted from core MWCCS visits. Logistic regression models were used to explore CIN2 regression (CIN1, normal) vs. persistence/progression (CIN2, CIN3). Log rank tests, Kaplan Meier method, and Cox regression modeling were used to determine CIN2 regression rates. RESULTS/ANTICIPATED RESULTS: The most prevalent HPV types were HPV54 (21.6%) and 53 (21.3%). 33 women (35.1%) had a subsequent CIN2/CIN3 diagnosis (median 12.5 years follow-up). Each additional hr-HPV type detected at the pre-CIN2 visit associated with increased odds of CIN2 persistence/progression (OR 2.27, 95% CI 1.15, 4.50). Higher vaginal pH (aOR 2.27, 95% CI 1.15, 4.50) and bacterial vaginosis (aOR 5.08, 95% CI 1.30, 19.94) at the CIN2 diagnosis visit associated with higher odds of CIN2 persistence/progression. Vaginal pH >4.5 at CIN2 diagnosis also associated with unadjusted time to CIN2 persistence/progression (log rank p=0.002) and a higher rate of CIN2 persistence/progression (adjusted hazard ratio [aHR] 3.37, 95% CI 1.26, 8.99). Cervicovaginal cytokine/chemokine levels were not associated with CIN2 persistence/progression. DISCUSSION/SIGNIFICANCE OF FINDINGS: We found relatively low prevalence of HPV16/18 in this cohort. Elevated vaginal pH at the time of CIN2 diagnosis may be a useful indicator of CIN2 persistence/progression and the rate of persistence/progression. |
| first_indexed | 2024-04-10T04:31:21Z |
| format | Article |
| id | doaj.art-0d37e9d4f3614efeb394caacfc995ce1 |
| institution | Directory Open Access Journal |
| issn | 2059-8661 |
| language | English |
| last_indexed | 2024-04-10T04:31:21Z |
| publishDate | 2021-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj.art-0d37e9d4f3614efeb394caacfc995ce12023-03-10T07:52:03ZengCambridge University PressJournal of Clinical and Translational Science2059-86612021-03-015232410.1017/cts.2021.46560941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virusKatherine Michel0Christine Colie1Robert D. Burk2L. Stewart Massad3Cuiwei Wang4Michaeline Hebron5Charbel Moussa6Gypsyamber D’Souza7Lisa Rahangdale8Lisa Flowers9Joel Milam10Joel M. Palefsky11Howard Minkoff12Howard D. Strickler13Seble G. Kassaye14Georgetown UniversityGeorgetown UniversityAlbert Einstein College of MedicineWashington University in St. LouisGeorgetown UniversityGeorgetown UniversityGeorgetown UniversityJohns Hopkins UniversityUniversity of North Carolina School of MedicineEmory UniversityUniversity of California IrvineUniversity of California San FranciscoMaimonides Medical CenterAlbert Einstein College of MedicineGeorgetown UniversityABSTRACT IMPACT: The potential to use vaginal pH as a low cost, non-invasive diagnostic test at the point of CIN2 diagnosis to predict worsening of cervical disease. OBJECTIVES/GOALS: We previously reported that persistence/progression of cervical intraepithelial neoplasia-2 (CIN2) was uncommon in women living with HIV (WLH) from the Women’s Interagency HIV Study (WIHS, now MWCCS). Here we examined additional factors that may influence CIN2 natural history. METHODS/STUDY POPULATION: A total of 337 samples from 94 WLH with a confirmed CIN2 diagnosis were obtained from the MWCCS. 42 cervicovaginal HPV types and 34 cervicovaginal cytokines/chemokines were measured at CIN2 diagnosis (94 samples) and 6-12 months prior to CIN2 diagnosis (79 samples). Covariates, including CD4 count and vaginal pH, were abstracted from core MWCCS visits. Logistic regression models were used to explore CIN2 regression (CIN1, normal) vs. persistence/progression (CIN2, CIN3). Log rank tests, Kaplan Meier method, and Cox regression modeling were used to determine CIN2 regression rates. RESULTS/ANTICIPATED RESULTS: The most prevalent HPV types were HPV54 (21.6%) and 53 (21.3%). 33 women (35.1%) had a subsequent CIN2/CIN3 diagnosis (median 12.5 years follow-up). Each additional hr-HPV type detected at the pre-CIN2 visit associated with increased odds of CIN2 persistence/progression (OR 2.27, 95% CI 1.15, 4.50). Higher vaginal pH (aOR 2.27, 95% CI 1.15, 4.50) and bacterial vaginosis (aOR 5.08, 95% CI 1.30, 19.94) at the CIN2 diagnosis visit associated with higher odds of CIN2 persistence/progression. Vaginal pH >4.5 at CIN2 diagnosis also associated with unadjusted time to CIN2 persistence/progression (log rank p=0.002) and a higher rate of CIN2 persistence/progression (adjusted hazard ratio [aHR] 3.37, 95% CI 1.26, 8.99). Cervicovaginal cytokine/chemokine levels were not associated with CIN2 persistence/progression. DISCUSSION/SIGNIFICANCE OF FINDINGS: We found relatively low prevalence of HPV16/18 in this cohort. Elevated vaginal pH at the time of CIN2 diagnosis may be a useful indicator of CIN2 persistence/progression and the rate of persistence/progression.https://www.cambridge.org/core/product/identifier/S2059866121004659/type/journal_article |
| spellingShingle | Katherine Michel Christine Colie Robert D. Burk L. Stewart Massad Cuiwei Wang Michaeline Hebron Charbel Moussa Gypsyamber D’Souza Lisa Rahangdale Lisa Flowers Joel Milam Joel M. Palefsky Howard Minkoff Howard D. Strickler Seble G. Kassaye 60941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virus Journal of Clinical and Translational Science |
| title | 60941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virus |
| title_full | 60941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virus |
| title_fullStr | 60941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virus |
| title_full_unstemmed | 60941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virus |
| title_short | 60941 Vaginal pH predicts cervical intraepithelial neoplasia-2 regression in women living with human immunodeficiency virus |
| title_sort | 60941 vaginal ph predicts cervical intraepithelial neoplasia 2 regression in women living with human immunodeficiency virus |
| url | https://www.cambridge.org/core/product/identifier/S2059866121004659/type/journal_article |
| work_keys_str_mv | AT katherinemichel 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT christinecolie 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT robertdburk 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT lstewartmassad 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT cuiweiwang 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT michaelinehebron 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT charbelmoussa 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT gypsyamberdsouza 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT lisarahangdale 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT lisaflowers 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT joelmilam 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT joelmpalefsky 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT howardminkoff 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT howarddstrickler 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus AT seblegkassaye 60941vaginalphpredictscervicalintraepithelialneoplasia2regressioninwomenlivingwithhumanimmunodeficiencyvirus |