Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, China
Abstract China lacks data demonstrating associations of cervical neoplastic lesions with CD4 T‐lymphocyte (CD4 cell) counts and antiretroviral therapy (ART) among HIV‐infected women, suggesting relevant investigations are needed. A total of 545 HIV‐infected women were enrolled in Yunnan, China, betw...
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/kjm2.12175 |
| _version_ | 1828857643798626304 |
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| author | Dong‐Yu Zhang Wen Chen Hong‐Yun Zhang Song‐Qin Lv Xiao‐Ning Lu Yan‐Ping Tao Mi Zhang Jia‐Fa Liu Min Yang You‐Lin Qiao Dejana Braithwaite |
| author_facet | Dong‐Yu Zhang Wen Chen Hong‐Yun Zhang Song‐Qin Lv Xiao‐Ning Lu Yan‐Ping Tao Mi Zhang Jia‐Fa Liu Min Yang You‐Lin Qiao Dejana Braithwaite |
| author_sort | Dong‐Yu Zhang |
| collection | DOAJ |
| description | Abstract China lacks data demonstrating associations of cervical neoplastic lesions with CD4 T‐lymphocyte (CD4 cell) counts and antiretroviral therapy (ART) among HIV‐infected women, suggesting relevant investigations are needed. A total of 545 HIV‐infected women were enrolled in Yunnan, China, between 2011 and 2013. CD4 cell counts and ART were measured via medical records and cervical neoplastic lesions were measured by professional pathologists. Multivariable logistic models, which treated cervical intraepithelial neoplasia (CIN) 1+ and CIN2+ as outcomes, calculated adjusted odds ratio (aOR) of CD4 cell counts and ART. Subgroup analysis treating CIN1+ as the outcome was conducted by HIV infection duration (<4 vs ≥4 years), ethnicity (Han vs non‐Han), and study site (Mangshi vs Kunming). The prevalence of CIN1+ and CIN2+ was 17.4% and 7.3%, respectively. Overall, 243 (44.6%) women had CD4 cell counts ≥500 cell/μL, 187 (34.3%) used ART for less than 2 years, and 236 (43.3%) used ART for at least 2 years. We found inverse associations of CIN1+ with CD4 cell counts (≥500 compared to <500 cells/μL: aOR = 0.46, 95% CI = 0.27‐0.79) and ART use (<2 years: aOR = 0.43, 95% CI = 0.21‐0.87; ≥2 years: aOR = 0.54, 95% CI = 0.27‐1.10). Point estimates did not change substantially for CIN2+ but aORs of ART became nonsignificant. No significant interaction was observed for HIV infection duration. We found significant interaction between CD4 cell counts and ethnicity and study site in relation to CIN1+. Our study suggests potential protective effects of high CD4 cell counts against cervical neoplastic lesions among HIV‐infected women, whereas associations of ART are less consistent. |
| first_indexed | 2024-12-13T01:40:41Z |
| format | Article |
| id | doaj.art-3432e8b7fb30474eb8400a2510e363c0 |
| institution | Directory Open Access Journal |
| issn | 1607-551X 2410-8650 |
| language | English |
| last_indexed | 2024-12-13T01:40:41Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-3432e8b7fb30474eb8400a2510e363c02022-12-22T00:03:45ZengWileyKaohsiung Journal of Medical Sciences1607-551X2410-86502020-06-0136645045910.1002/kjm2.12175Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, ChinaDong‐Yu Zhang0Wen Chen1Hong‐Yun Zhang2Song‐Qin Lv3Xiao‐Ning Lu4Yan‐Ping Tao5Mi Zhang6Jia‐Fa Liu7Min Yang8You‐Lin Qiao9Dejana Braithwaite10Department of Oncology Georgetown University School of Medicine Washington District of ColumbiaDepartment of Cancer Epidemiology Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Obstetrics and Gynecology Kunming Medical University Kunming ChinaDepartment of Obstetrics and Gynecology Kunming Medical University Kunming ChinaDepartment of Obstetrics and Gynecology Kunming Medical University Kunming ChinaDepartment of Obstetrics and Gynecology Kunming Medical University Kunming ChinaDepartment of HIV/AIDS Clinical Research Yunnan Provincial Hospital of Infectious Disease, AIDS Care Center (YNACC) Kunming ChinaDepartment of HIV/AIDS Clinical Research Yunnan Provincial Hospital of Infectious Disease, AIDS Care Center (YNACC) Kunming ChinaDepartment of Epidemiology University of North Carolina at Chapel Hill Gillings School of Global Public Health Chapel Hill North CarolinaDepartment of Cancer Epidemiology Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Oncology Georgetown University School of Medicine Washington District of ColumbiaAbstract China lacks data demonstrating associations of cervical neoplastic lesions with CD4 T‐lymphocyte (CD4 cell) counts and antiretroviral therapy (ART) among HIV‐infected women, suggesting relevant investigations are needed. A total of 545 HIV‐infected women were enrolled in Yunnan, China, between 2011 and 2013. CD4 cell counts and ART were measured via medical records and cervical neoplastic lesions were measured by professional pathologists. Multivariable logistic models, which treated cervical intraepithelial neoplasia (CIN) 1+ and CIN2+ as outcomes, calculated adjusted odds ratio (aOR) of CD4 cell counts and ART. Subgroup analysis treating CIN1+ as the outcome was conducted by HIV infection duration (<4 vs ≥4 years), ethnicity (Han vs non‐Han), and study site (Mangshi vs Kunming). The prevalence of CIN1+ and CIN2+ was 17.4% and 7.3%, respectively. Overall, 243 (44.6%) women had CD4 cell counts ≥500 cell/μL, 187 (34.3%) used ART for less than 2 years, and 236 (43.3%) used ART for at least 2 years. We found inverse associations of CIN1+ with CD4 cell counts (≥500 compared to <500 cells/μL: aOR = 0.46, 95% CI = 0.27‐0.79) and ART use (<2 years: aOR = 0.43, 95% CI = 0.21‐0.87; ≥2 years: aOR = 0.54, 95% CI = 0.27‐1.10). Point estimates did not change substantially for CIN2+ but aORs of ART became nonsignificant. No significant interaction was observed for HIV infection duration. We found significant interaction between CD4 cell counts and ethnicity and study site in relation to CIN1+. Our study suggests potential protective effects of high CD4 cell counts against cervical neoplastic lesions among HIV‐infected women, whereas associations of ART are less consistent.https://doi.org/10.1002/kjm2.12175antiretroviral therapyCD4 T‐lymphocytecervical cancerepidemiologyHIV |
| spellingShingle | Dong‐Yu Zhang Wen Chen Hong‐Yun Zhang Song‐Qin Lv Xiao‐Ning Lu Yan‐Ping Tao Mi Zhang Jia‐Fa Liu Min Yang You‐Lin Qiao Dejana Braithwaite Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, China Kaohsiung Journal of Medical Sciences antiretroviral therapy CD4 T‐lymphocyte cervical cancer epidemiology HIV |
| title | Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, China |
| title_full | Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, China |
| title_fullStr | Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, China |
| title_full_unstemmed | Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, China |
| title_short | Cervical neoplastic lesions in relation to CD4 T‐lymphocyte counts and antiretroviral therapy among women with clinical stage 1 HIV in Yunnan, China |
| title_sort | cervical neoplastic lesions in relation to cd4 t lymphocyte counts and antiretroviral therapy among women with clinical stage 1 hiv in yunnan china |
| topic | antiretroviral therapy CD4 T‐lymphocyte cervical cancer epidemiology HIV |
| url | https://doi.org/10.1002/kjm2.12175 |
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