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Abstract：
BACKGROUND: Uganda has approximately 1.2 million people aged 15-64 years living with human immunodeficiency virus (HIV). Previous studies have shown a higher prevalence of premalignant cervical lesions among HIV-positive women than among HIV-negative women. Additionally, HIV-infected women are more likely to have human papilloma virus (HPV) infection progress to cancer than women not infected with HIV. We determined the prevalence of premalignant cervical lesions and their association with HIV infection among women attending a cervical cancer screening clinic at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda.
METHODS: We conducted a comparative cross-sectional study of 210 women aged 22-65 years living with HIV and 210 women not living with HIV who were systematically enrolled from March 2022 to May 2022. Participants were subjected to a structured interviewer-administered questionnaire to obtain their demographic and clinical data. Additionally, Papanicolaou smears were obtained for microscopy to observe premalignant cervical lesions. Multivariate logistic regression was performed to determine the association between HIV status and premalignant cervical lesions.
RESULTS: The overall prevalence of premalignant cervical lesions in the study population was 17% (n = 72; 95% C.I: 14.1-21.4), with 23% (n = 47; 95% C.I: 17.8-29.5) in women living with HIV and 12% (n = 25; 95% C.I: 8.2-17.1) in women not living with HIV (p < 0.003). The most common premalignant cervical lesions identified were low-grade squamous intraepithelial lesions (LSIL) in both women living with HIV (74.5%; n = 35) and women not living with HIV (80%; n = 20). HIV infection was significantly associated with premalignant lesions (aOR: 2.37, 95% CI: 1.27-4.42; p = 0.007).
CONCLUSIONS: Premalignant cervical lesions, particularly LSILs, were more common in HIV-positive women than in HIV-negative women, highlighting the need to strengthen the integration of cervical cancer prevention strategies into HIV care programs.
METHODS: We conducted a comparative cross-sectional study of 210 women aged 22-65 years living with HIV and 210 women not living with HIV who were systematically enrolled from March 2022 to May 2022. Participants were subjected to a structured interviewer-administered questionnaire to obtain their demographic and clinical data. Additionally, Papanicolaou smears were obtained for microscopy to observe premalignant cervical lesions. Multivariate logistic regression was performed to determine the association between HIV status and premalignant cervical lesions.
RESULTS: The overall prevalence of premalignant cervical lesions in the study population was 17% (n = 72; 95% C.I: 14.1-21.4), with 23% (n = 47; 95% C.I: 17.8-29.5) in women living with HIV and 12% (n = 25; 95% C.I: 8.2-17.1) in women not living with HIV (p < 0.003). The most common premalignant cervical lesions identified were low-grade squamous intraepithelial lesions (LSIL) in both women living with HIV (74.5%; n = 35) and women not living with HIV (80%; n = 20). HIV infection was significantly associated with premalignant lesions (aOR: 2.37, 95% CI: 1.27-4.42; p = 0.007).
CONCLUSIONS: Premalignant cervical lesions, particularly LSILs, were more common in HIV-positive women than in HIV-negative women, highlighting the need to strengthen the integration of cervical cancer prevention strategies into HIV care programs.
摘要：
背景：乌干达大约有120万年龄在15-64岁之间的人患有人类免疫缺陷病毒（HIV）。先前的研究表明，HIV阳性妇女的宫颈癌前病变患病率高于HIV阴性妇女。此外,与未感染HIV的女性相比，感染HIV的女性更有可能将人乳头瘤病毒（HPV）感染发展为癌症。我们确定了在乌干达西南部Mbarara地区转诊医院（MRRH）的宫颈癌筛查诊所就诊的女性中，癌前宫颈病变的患病率及其与HIV感染的关系。
方法：我们对2022年3月至2022年5月系统登记的210名22-65岁感染艾滋病毒的女性和210名未感染艾滋病毒的女性进行了横断面比较研究。参与者接受结构化的面试官调查问卷，以获得他们的人口统计学和临床数据。此外,获得巴氏涂片进行显微镜检查以观察宫颈癌前病变。采用多因素logistic回归分析确定HIV状态与宫颈癌前病变之间的关系。
结果：研究人群中宫颈癌前病变的总体患病率为17％（n=72；95％C.I：14.1-21.4），其中23%(n=47;95%C.I:17.8-29.5)的感染艾滋病毒的妇女和12%(n=25;95%C.I:8.2-17.1)的未感染艾滋病毒的妇女(p<0.003)。在感染HIV的妇女（74.5％；n=35）和未感染HIV的妇女（80％；n=20）中，最常见的癌前宫颈病变是低度鳞状上皮内病变（LSIL）。HIV感染与癌前病变显着相关（aOR：2.37，95％CI：1.27-4.42；p=0.007）。
结论：宫颈癌前病变，特别是LSIL,在艾滋病毒呈阳性的女性中比在艾滋病毒呈阴性的女性中更常见，强调需要加强将宫颈癌预防战略纳入艾滋病毒护理计划。
方法：我们对2022年3月至2022年5月系统登记的210名22-65岁感染艾滋病毒的女性和210名未感染艾滋病毒的女性进行了横断面比较研究。参与者接受结构化的面试官调查问卷，以获得他们的人口统计学和临床数据。此外,获得巴氏涂片进行显微镜检查以观察宫颈癌前病变。采用多因素logistic回归分析确定HIV状态与宫颈癌前病变之间的关系。
结果：研究人群中宫颈癌前病变的总体患病率为17％（n=72；95％C.I：14.1-21.4），其中23%(n=47;95%C.I:17.8-29.5)的感染艾滋病毒的妇女和12%(n=25;95%C.I:8.2-17.1)的未感染艾滋病毒的妇女(p<0.003)。在感染HIV的妇女（74.5％；n=35）和未感染HIV的妇女（80％；n=20）中，最常见的癌前宫颈病变是低度鳞状上皮内病变（LSIL）。HIV感染与癌前病变显着相关（aOR：2.37，95％CI：1.27-4.42；p=0.007）。
结论：宫颈癌前病变，特别是LSIL,在艾滋病毒呈阳性的女性中比在艾滋病毒呈阴性的女性中更常见，强调需要加强将宫颈癌预防战略纳入艾滋病毒护理计划。
