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Retrospective cohort of incidence of intraepithelial lesions in female genital tract in women living with HIV in use of therapy antiretroviral

Grant number: 17/04235-3
Support type:Scholarships in Brazil - Scientific Initiation
Effective date (Start): July 01, 2017
Effective date (End): June 30, 2018
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Silvana Maria Quintana
Grantee:Sara Caixeta de Souza
Home Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Background/Rationale: HPV infection are among sexually transmitted diseases (STD) more common in the world. Persistent infection with high-risk HPV is one of the most important factors for the progression of high-grade squamous intraepithelial lesion to cervical cancer. It is known that 90% of women will eliminate the virus in a period of two years, and this process related to the immune capacity of the body. In this context, studies demonstrate a high prevalence of persistent infection with high-risk HPV and cervical cancer in women living with HIV despite the apparent immune reconstitution observed with the use of antiretroviral therapy (HAART) with consequent increase in CD4 T lymphocyte levels and reduction in viral load. The literature review shows that there is no proper understanding of the natural history of HPV infection in women living with HIV after the introduction of HAART and clinical observation Sector of Infectious Diseases in Obstetrics and Gynecology (SEMIGO) is that accompanied patients with adequate control of HIV infection have a higher prevalence of HPV infection, but do not have a higher incidence of HSIL or invasive carcinoma of the cervix. Objective: The aim of this study is to evaluate the incidence of LEL in women living with HIV in HAART. Secondary objectives are to compare the incidence of LEL among women living with HIV in use or not of antiretroviral therapy, the influence of other risk factors such as smoking, other STDs, use of hormonal contraception, number of partners in the incidence of LEL and how to evaluate the association between CD4 cell count and HIV viral load and the incidence of LEL. Methods: A retrospective cohort of women living with HIV who consulted in SEMIGO the 10-year period will be held (2007-2016), in use of HAART or not. The information will be obtained by access to SEMIGO database. Keywords: HIV, HPV, cervical pre-neoplastic lesion, cervical intraepithelial lesion, antiretroviral therapy, CD4, viral load (AU)