HIV infection and invasive cervical cancer in South Africa. Patrick Lomalisa FCOG ,MPH (SA),Trudy Smith FCOG (SA) and Franco Guidozzi FCOG,PhD (SA). Johannesburg Hospital, Wits University (SA) Gaborone October 2007. Introduction.
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HIV infection and invasive cervical cancer in South Africa
Patrick Lomalisa FCOG ,MPH (SA),Trudy Smith FCOG (SA) and Franco Guidozzi FCOG,PhD (SA).
Johannesburg Hospital, Wits University (SA)
Determine if HIV(+) with invasive cervical
cancer had more advanced lesions
than HIV(-) women.
Determine if degree of immunity affects the stage of disease at presentation.
60 HIV(+) 776 HIV(-) p-value
Mean 44+9.8 53+12.7 <0.001
Range 28-70 15-90
<30 2(3.3) 9(1.1)
>/=50 16(27.7) 450(68.2)
3(0-9) 4(0-14) NS
SCC 55(91.6) 725(93.4) NS
Stages 3&4 39(65) 430(55.4) NS
-Johannesburg ; Sitas et al 3.5%(1997) and lomalisa et
al 7.2%(2000). Moodley et al (2006) in Durban found no increase
of prevalence (21 % in 1999 and 21.8% in 2003) but a
decrease of number of new cases of invasive cervical cancer (672 in 1999 to
271 in 2003).
-Moodley J R et al in Cape Town (2006) found an increase risk of cervical pre-
cancer but no relation between HIV infection and invasive cervical cancer. HIV (+)
women : 5 times high risk of HPV infection and HPV +HIV(+) :40 Times risk for SIL
3 parameters : increase risk with decrease CD4 ,reduction of risk by HAART and improved survival by HAART.
Since HAART in 1996,no evidence with cancer of cervix but good evidence for Kaposi Sarcoma and non-Hodgkin lymphoma.
If good prevention program, no increase prevalence of ICC among HIV-infected women (Massad et al,2004;USA).
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