Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lower genital tract neoplasia appears to occur often and in multiple sites in women infected with the human immunodeficiency virus (HIV). To describe the prevalence of lower genital tract neoplasia in HIV-infected women in our clinic we performed a retrospective chart review of 38 HIV-infected women who had received screening colposcopy. Fourteen percent of the women had VIN on biopsy. In addition, 50% of the women had abnormal Pap smears and 24% had CIN on biopsy. In this study, lower genital tract neoplasia was multifocal in nature and included a relatively high prevalence of VIN not previously reported in the literature.
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PMID:Multifocal lower genital tract neoplasia in women with HIV disease. 761 25

The authors underline a synergism of HPV + HSV and HPV + CIN that, together with general immunodeficiency and local factors are responsible for the oncogenesis of cervico carcinoma. This thesis takes on importance after literature reports of an increase of 10% in viral infections from HSV and HPV with a middle incidence of the 1-2% in all the colpocytologic examination cases not in women between 18 and 65 years. To obtain a successful preventive treatment the authors recommend a colpocytologic examination each year, possibly in association with colposcopic, histologic and molecular studies in all HPV positive cases.
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PMID:[The Pap-test in the study of viral infections of the female genital tract]. 763 May 8

The Human Papilloma Virus is often involved in the pathogenesis of cervical lesions. A local or systemic immunodeficiency allows neoplasia outbreaks. We do not know if immunodepression only allows the virus to persist, or if the HPV induces a local immunodeficiency. Large warts are often associated with pregnancy, but cervical cancers are not increased in pregnant women. Induced immunodeficiency (among transplanted patients), or AIDS increase the rate of CIN and cervical cancers. The more serious the immunodeficiency is, the more multifocal and recurrent the lesions are. We have to look for an immunodepression and for AIDS when we observe multifocal or recurrent lesions of the cervix, specially when the lesions do not regress under correct treatment. Immunodeficient women would benefit from closer care of their cervix. We think that combine therapy (e.g. laser and local interferon) would be more efficient in case of immunodeficiency.
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PMID:[Cervical pathology and immunodepression]. 782 39

A total of 158 women who either HIV-infected or under iatrogenic immunosuppression were examined regularly during a 4-year period to evaluate if certain vulvar neoplasms and cervical neoplasia have similar associated risk factors. Patients with CIN were matched prospectively with immunocompetent controls with CIN. Forty-eight cervical lesions were detected among patients, including 2 invasive carcinoma and 15 CIN-3 lesions, compared to 11 vulvar lesions, including 2 invasive carcinoma and 7 VIN-3 lesions. Women who have more than five life-time partners were more likely to have HPV-DNA positive cervical swabs and vulvar scrapes as well as cervical and/or vulvar neoplasia. Compared to 2.7% of controls 15.2% of patients with CIN had coexisting high-grade lesions of the vulva. With 1 exception all patients with vulvar neoplasia either suffered from symptomatic immunodeficiency or received immunosuppressive drugs for more than 10 years. Except for 1 VIN-3 lesions, all vulvar neoplasms were associated with HPV-DNA types 16, 31, and/or 33. Six of nine patients as well as the 2 controls with coexisting vulvar and cervical neoplasia had the same HPV-type associated with both lesions. All vulvar lesions were classified as either "warty" or "basaloid". In conclusion cervical and bowenoid/basaloid vulvar neoplasia seem to have a similar HPV-related genesis. Malfunction of the cellular immune response appears to be a cofactor in the genesis of HPV-associated neoplasia at both sites.
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PMID:Human papillomavirus is associated with the frequent detection of warty and basaloid high-grade neoplasia of the vulva and cervical neoplasia among immunocompromised women. 855 24

The hypothesis tested was that there is an association between the presence of proliferating (MiB-1-positive) cervical cells and clinical outcome of women infected with human immunodeficiency virus (HIV). Female partners (attending the Gynecology Outpatients Clinic of the University Hospital of Rio Grande, Brazil) of known HIV-positive (HIV+) men were used for this pilot study. Among these women, 25 were also HIV+. Papanicolaou smears of these 25 HIV+ women and of 44 HIV- women were graded as negative, CIN I, CIN II, or CIN III, using neural network screening. MiB-1 grading and HPV identification were also performed. The immune status of patients was determined using the current Centers for Disease Control classification. In agreement with the scientific literature, in these Brazilian women both CIN and HPV were associated with HIV. In the HIV+ women, the immune status tends to correlate with MiB-1 grading. Also, in the one case in whom progression from CIN I to invasive cervical carcinoma was observed, the smear contained many MiB-1-positive cells. Staining cervical smears of HIV+ women is a simple procedure to get an indication of clinical outcome of the patient.
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PMID:Presence of proliferating (MiB-1-positive) cells in cervical smears of women infected with HIV is associated with clinical outcome: a study of Brazilian women. 1139 16

Intraepithelial neoplasia of the cornea and conjunctiva (CIN) and squamous cell carcinoma (SCC) lie on a continuum of the same dysplastic process. The etiology of this disease is most likely multifactorial, involving such factors as age, fair pigmentation, ultraviolet light exposure, human papillomavirus, and human immunodeficiency virus (HIV). It is known that CIN and SCC have a high recurrence rate after excision alone. Cryotherapy, radiation, and chemotherapeutics have been used after excision to reduce recurrence rates. More recently, mitomycin-C, 5-fluorouracil, and interferon-alpha-2b have been successfully employed alone against CIN and SCC, thereby eliminating the need for surgical excision altogether. The various treatments for CIN and SCC are reviewed and discussed.
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PMID:Current treatment options for conjunctival and corneal intraepithelial neoplasia. 1707 34

Integrated human papillomavirus type 16 (HPV-16) viral loads are currently estimated by quantification with real-time PCR of HPV-16 E6 (RT-E6 and HPV-16 PG) and E2 (RT-E2-1) DNA. We assessed the influence of HPV-16 E2 polymorphism on quantification of integrated HPV-16 DNA in anogenital specimens. HPV-16 E2 was sequenced from 135 isolates (123 from European and 12 from non-European lineages). An assay targeting conserved HPV-16 E2 sequences (RT-E2-2) was optimized and applied with RT-E6 and RT-E2-1 on 139 HPV-16-positive cervicovaginal lavages collected from 74 women [58 human immunodeficiency virus (HIV)-seropositive and 16 HIV-seronegative]. Ratios of HPV-16 copies measured with RT-E2-2 and RT-E2-1 obtained with African 2 (median=3.23, range=1.92-3.49) or Asian-American (median=3.78, range=1.47-37) isolates were greater than those obtained with European isolates (median=1.02, range=0.64-1.80; P<0.02 for each comparison). The distribution of HPV-16 E2 copies measured in 139 samples with RT-E2-2 (median=6150) and RT-E2-1 (median=8960) were different (P<0.0001). The risk of high-grade cervical intraepithelial neoplasia (CIN-2,3) compared with women without CIN was increased with higher HPV-16 total [odds ratio (OR)=2.17, 95 % confidence interval (CI)=1.11-4.23], episomal (OR=2.14, 95 % CI=1.09-4.19), but not for HPV-16 integrated viral load (OR=1.71, 95 % CI=0.90-3.26), after controlling for age, race, CD4 count, HIV and HPV-16 polymorphism. The proportion of samples with an E6/E2 ratio >2 in women without squamous intraepithelial lesion (7 of 35) was similar to that of women with CIN-2,3 (5 of 11, P=0.24) or CIN-1 (5 of 14, P=0.50). HPV-16 E2 polymorphism was a significant factor that influenced measures of HPV-16 integrated viral load.
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PMID:Influence of human papillomavirus type 16 (HPV-16) E2 polymorphism on quantification of HPV-16 episomal and integrated DNA in cervicovaginal lavages from women with cervical intraepithelial neoplasia. 1855 43

Increasing numbers of human immunodeficiency virus (HIV)-infected women are now accessing life-prolonging highly active antiretroviral therapy (HAART) in developing countries. There is a need for better understanding of interactions of human papillomavirus (HPV) and HIV, especially in the context of increasing life expectancy due to HAART. The data regarding the impact of HAART on reducing the incidence and progression and facilitating the regression of HPV infection and cervical abnormalities is largely inconsistent. Published studies differ in their study designs (prospective or retrospective cohorts or record linkage studies), screening and diagnostic protocols, duration and type of HAART use, recruitment and referral strategies, and definitions of screening test and disease positivity. Due to the ethical and resource limitations in conducting randomized trials of the impact of HAART on incidence of HPV, CIN, and cervical cancer among HIV-infected women, it is important to consider innovative study designs, including quasi-experimental trials and operations research in sentinel populations to answer the critical research questions in this area.
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PMID:The impact of antiretroviral therapy on HPV and cervical intraepithelial neoplasia: current evidence and directions for future research. 2046 41

We performed an observational cohort study in order to assess the correlation between precancerous cervical lesions (cervical intraepithelial neoplasia [CIN]) and immunological state in human immunodeficiency virus (HIV)-positive women treated by highly active antiretroviral therapy (HAART). We analyzed 194 HIV-infected women referred to the Parma-Universitary Hospital for early detection of human papilloma virus-induced CINs. We analyzed cytology, colposcopy, and CIN degree according to HAART: group A untreated and group B treated. We compared the CD4+ count and viral load at the time of CIN onset and the time interval between diagnosis of HIV and the onset of CIN. Group A and group B showed homogeneous results for general features, CD4+ count, viral load, and Papanicolaou test features. Differences were not found in terms of histology and CD4+ value, viral load count, pharmacological treatment, years since the diagnosis of HIV, age, smoking, sexual promiscuity, previous intravenous narcotics abuse, prostitution, sexually transmitted diseases, ethnicity, and age at diagnosis. Histology and the clinical stage of HIV showed significant concordances between the high degree of cervical dysplasia and advanced stage of HIV disease.
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PMID:Impact of Highly Active Antiretroviral Therapy on the Natural History of Cervical Precancerous Lesions: A 17-Year Institutional Longitudinal Cohort Study. 2433 75