Is human papillomavirus-related disease an independent risk factor for human immunodeficiency virus infection?

Citations from the Literature

307

intake is provided for 2 6 months) is associated with bone 10s~; however, there is evidente of return to baseline BMD measurement at 12 months after parturition.

ly, no relation emerged between CIN risk and age, indicators of sexual habits, oral contraceptive use, parity, and history of spontaneous or induced abortions.

INFECTIOUS

Is tmman papillomavirus-related disease on independent risk factor for lmman immunadeficiency virus infection?

DISEASES

Humaa immmmdefíciency vims infection among patients in a gyaecology emergency department

Lindsay M.K.; Grant J.; Peterson H.B.; Risby J.; Williams H.; Klein L. USA OBSTET GYNECOL 1993 81/6 (1012-1015) Objective: To determine the extent of human immunodeficiency virus (HIV) infection risk factors and the relationship to the clinical diagnosis in women seen in a busy inner-city gynecology emergency department. Methods: We performed a cross-sectional survey by offering routine voluntary HIV-1 antibody screening and obtaining HIV risk behavior profiles in 1033 (35%) of 2952 women seeking care in our gynecology emergency department during a 5-week period. Results: The HIV seroprevalence was 2%. Six (35%) of the infected women reported a history of intravenous drug use, tïve (29%) reported a history of crack cocaine use, and tïve (29%) reported no risk factors for infection. Seropositive women were more likely than were seronegative women to have clinical symptoms consistent with pelvic infiammatory disease (18 vs. 3%; P < 0.01). Conclusion: These data sugest that women attending the gpxoiogyemergency room in our hospita1 are at substantial risk for HIV infection.

HFV, HfV infection, and risk of cervical intraepitbelial neoplasia ia fermer iatraveaous drug ebusers

Conti M.; Agarossi A.; Parazzini F.; Muggiasca M.L.; Boschini A.; Negri E.; Casolati E. ITA GYNECOL ONCOL 1993 49/3 (344-348) The relation between human immunodetïciency virus (HIV), human papilloma virus (HPV) infection, sexual habits, reproductive history, and risk of cervical intraepithehal neoplasia (CIN) has been analyzed in a cross-sectional study conducted since 1986 among female former intravenous drug abusers attending for the Brst time to the Colposcopic Unit of the Ospedale Luigi Sacco of Milan and women consecutively admitted to the Community for Past Drug Abusers, S. Patrignano, Rimini. A total of 434 subjects entered the study; of those 128 (39%) had a diagnosis of CIN. Compared with HIV-negative subjects, odds ratio (OR) of CIN was 8.0 (95% confidence interval (CI) 4.6-14.1) for HIV-positive ones and the frequency of CIN 2 and 3 was higher in HIV-positive than that in HIV-negative subjects (chi2t trend, 6.67, P = 0.01). Compared with women without current HPV infection the OR estimate was 38.0 (95% CI 20.3-71.2) in those with current diagnosis of HPV infection. Considering HIV-positive subjects only, the frequency of CIN increased with stage of HIV infection and was higher in women with lower CD4+ values. Final-

Spitzer M.; Brennessel D.; Seltzer V.L.; Silver L.; Lox M.S. USA GYNECOL ONCOL 1993 4912 (243-246) We sought to determine the prevalente of human immunodefïciency virus (HIV) infection in a population of women with human papillomavirus (HPV)-related diseases attending a colposcopy clinic who had no other CDC-defined risk factors for HIV. Study patients included al1 new patients attending om colposcopy chnic who were found to have histologie evidente of condyloma or cervical intraepithelial neoplasia. Those patients not already known to be HIV-positive were offered testing for HIV. Demographic information was obtained on al1 patients. Resuhs were compared to data from anonymous testing of our own obstetrical population. One hundred forty of 208 women (67.3%) were either previously known to be HIVpositive or agreed to be tested. Sixteen (11.4%) were HIVpositive. Eight of the HIV-positive women were not previously known to be HIV-positive and 6 of the 8 had no definable risk factors for HIV infection. This is 4.6% of the women not already known to have a CDC-detïned risk factor for HIV. The rate of HIV infection in our obstetrical population is 1.6%. In women without other defínable risks for HIV infection and who had HPV-related disease the relative risk of HIV infection in our population was 2.94 (95% confidence interval 1.21-6.94; P < 0.031). In areas where HIV is endemie there is a high prevalenoe of HIV infection in women with HPV-related disease. Even in women without another detínable risk factor for HIV, HPV-related disease may serve as a marker for an increased risk of HIV infection A population-ba4

in this population.

assessment of invasive disease due to group

B streptooccus in nonpregnant adults Farley M.M.; Harvey R.C.; Stull T.; Smith J.D.; Schuchat A.; Wenger J.D.; Stephens DS. USA NEW ENGL J MED 1993 328/25 (1807-1811) Background. Group B streptococci (Streptococcus agalactiae) are a major cause of meningitis and septicemia in neonates and pregnant women, but the importante of group B streptococcal disease in nonpregnant adults has not been clearly detïned. Methods. We conducted a prospective surveillance of the pathogens responsible for meningitis for a period of 24 months in 35 hospitals and a referral laboratory in metropolitan Atlanta. We reviewed the chnical and laboratory records of al1 the nonpregnant adults identified as having invasive group B streptococcal disease during this period. Results. During 1989 and 1990 there were 424 patients with invasive group B streptococcal disease (annual incidence, 9.2 cases per 100 000 population). Of these patients, 46% were 1 month of age or younger, 6% were older than 1 month but younger than 18 years of age, and 48% were 18 or older. Men

Int J Gynecol Obstet 44