Anal and Cervical Cytologic Abnormalities among HIV-Infected Women on HAART Remain Prevalent at 12 months in the Study to Understand the Natural History.

Slides:

Advertisements

Similar presentations

Persistence of HPV in a cohort of female adolescents Erika Samoff, Emilia H. Koumans, Lauri E. Markowitz, Maya Sternberg, Mary K. Sawyer, David Swan, John.

Advertisements

Florida Department of Health HIV/AIDS Section Division of Disease Control and Health Protection Annual data trends as of 12/31/2013 Living (Prevalence)

HIV/AIDS In The United States J.AD.DA.S. Table of Contents Epidemiology AIDS in the United States AIDS by ethnicity AIDS by exposure category AIDS deaths.

Delay from Testing HIV Positive until First HIV Care for Drug Users: Adverse Consequences and Possible Solutions Barbara J Turner MD, MSEd* John Fleishman.

SPECTRUM OF CARE ENGAGEMENT-ARIZONA PREVALENT CASES 2012 Note: HIV infected is derived using CDC’s national infection estimation guidelines.

HIV/AIDS AMONG LATINOS IN NEW JERSEY presented by: Gloria M. Rodriguez, DSW Assistant Commissioner Division of AIDS Prevention and Control presented at.

Routine HIV Screening in Health Care Settings David Spach, MD Clinical Director Northwest AIDS Education and Training Center Professor of Medicine, Division.

M. Munjoma. Outline Burden of HPV Disease HPV in Zimbabwe HPV Lab Development HPV Protocols.

HIV Disease in Older Patients Donna M. Gallagher, ANP The International AIDS Society–USA DM Gallagher, ANP. Presented at IAS–USA/RWCA Clinical Conference,

Role of Antiretroviral Therapy, Viral Replication, and HIV Infection in Atherosclerosis Priscilla Y. Hsue, Peter W. Hunt, Jeffrey N. Martin, Amanda Schnell,

Enhancing HIV/AIDS Surveillance in California California Department of Public Health Office of AIDS Guide for Health Care Providers.

Anal Human Papillomavirus Infection in HIV-Infected Men Who Have Sex With Men (MSM) and Men Who Have Sex with Women (MSW) in the SUN Study John T. Brooks1,

Risk factors for Incident Trichomonas vaginalis among Women Recruited in RESPECT-2, an HIV Prevention Trial D Helms 1, D Mosure 1, T Peterman 1, C Metcalf.

Patients in routine HIV clinical care at-risk for potentially transmitting HIV in the “test and treat” era of HIV prevention Crane, HM, Mimiaga, M, Feldman,

Educational Module Cervical Cancer Screening.  Estimated new cases: 610  Estimated deaths: 150 Regular Pap tests combined with the HPV vaccine can.

HIV Infection Among Those with an Injection Drug Use*- Associated Risk, Florida, 2012 Florida Department of Health HIV/AIDS and Hepatitis Section Division.

Routine HIV Screening in Health Care Settings David Spach, MD Clinical Director Northwest AIDS Education and Training Center Professor of Medicine, Division.

Persisting long term benefit of genotypic guided treatment in HIV infected patients failing HAART and Importance of Protease Inhibitor plasma levels. Viradapt.

Epidemiology of HIV Among Asians and Pacific Islanders Reported in Florida, Through 2014 Florida Department of Health HIV/AIDS Section Division of Disease.

Prevalence and Risk Factors in HIV-infected Persons for Echocardiographic Abnormalities in the Era of Modern HAART  The natural history of HIV infection.

Washington D.C., USA, July 2012www.aids2012.org HCV genotype and HBV co-infection associate with HCV clearance in HIV- positive subjects Yuan Dong,

Impact of tuberculosis screening and isoniazid preventive therapy on incidence of TB and death in the TB/HIV in Rio de Janeiro (THRio) study B. Durovni1,2,

Africans and HIV in the UK: an epidemiological perspective Nov 2006 Tim Chadborn On behalf of the HIV Reporting Section with special thanks to Julia Abernethy.

1 Is Managed Care Superior to Traditional Fee-For-Service among HIV-Infected Beneficiaries of Medicaid? David Zingmond, MD, PhD UCLA Division of General.

Racial Disparities in Antiretroviral Therapy Use and Viral Suppression among Sexually Active HIV-infected Men who have Sex with Men— United States, Medical.

Wisconsin Department of Health Services HIV/AIDS Surveillance Annual Review New diagnoses, prevalent cases, and deaths through December 31, 2013 April.

THE BODY PRO The HIV Resource for Health Care Professionals Copyright © 2009 The HealthCentral Network, Inc. All rights reserved. This activity is jointly.

ABSTRACT Introduction: HIV infection is growing relatively fast among seniors. Among the clinical implications are that older patients have less ability.

Colorado Department of Public Health and Environment Tuberculosis Prevention and Control Program.

Background There is uncertainty regarding the frequency, predictors, and outcomes of IRIS events Prior studies on IRIS have been limited to convenience.

Older and wiser: continued improvements in clinical outcome and highly active antiretroviral therapy (HAART) response in HIV-infected children in the UK.

Amita Toprani, MD, MPH New York City Department of Health & Mental Hygiene EIS Field Assignments Branch Centers for Disease Control and Prevention CSTE.

Using HIV Surveillance to Achieve High Impact Prevention Irene Hall, PhD, FACE AIDS 2012 High-Impact Prevention: Reducing the HIV Epidemic in the United.

Transition Program of HIV-infected adolescents to Adult HIV care in Buenos Aires, Argentina S. Arazi Caillaud 1, D. Mecikovsky 1, A.Bordato.

The Impact of Introducing “Express Visits” for Asymptomatic Persons Seeking STD Services in a Busy Urban STD Clinic System, Borrelli J 1, Paneth-Pollak.

#735 KA Lichtenstein 1, C Armon 2, K Buchacz 3, AC Moorman 3, KC Wood 2, JT Brooks 3, and the HOPS Investigators 1 University of Colorado Health Sciences.

Antiretroviral Treatment Monitoring: A Canadian Case Example Antiretroviral Treatment Monitoring: A Canadian Case Example Robert Hogg, PhD BC Centre for.

Impact of Highly Active Antiretroviral Therapy on the Incidence of HIV- encephalopathy among perinatally- infected children and adolescents. Kunjal Patel,

Background ●Osteoporosis is characterized by low bone mass leading to increased bone fragility and increase in fracture risk, particularly the vertebrae,

Aidsnet.org Miami-Dade County HIV/AIDS Epidemiological Data October 25, 2011 Data provided by the Florida Department of Health HIV/AIDS Surveillance Program.

HIV Infection Among Those with an Injection Drug Use*-Associated Risk, Florida, 2014 Florida Department of Health HIV/AIDS Section Division of Disease.

Neurocognitive Impairment in HIV-Infected Subjects on HAART: Prevalence and Associations Kevin Robertson *1, Kunling Wu 2, Thomas Parsons 1, Ron Ellis.

INTRODUCTION Evaluation of Outcomes in Patients Starting Antiretroviral Therapy During Hospitalization Leigh E. Efird, PharmD 1, Manish Patel, PharmD 1,

Immune Discordance on Highly Active Antiretroviral Therapy Can Still be Regarded as a Therapeutic Success Nur F. Önen MD, MRCP 1, Rachel Presti MD PhD.

Factors Associated with Survival in HIV-Infected African Patients on Antiretroviral Therapy: The Impact of a Sampling-Based Approach to Address Losses.

Results Compliance with Breast Cancer Screening Guidelines in the HIV Clinic: A Quality Improvement Tool E. Patrozou M.D., E. Christaki M.D., L. Hicks.

Efficacy of immunization among HIV infected adults: An Observation R Bansal, N Gupta Crosslay AIDS & Wellness Centre Pushpanjali Crosslay Hospital Vaishali.

Epidemiology of HIV Among Hispanics Reported in Florida, Through 2014 Florida Department of Health HIV/AIDS Section Division of Disease Control and Health.

Florida Department of Health HIV/AIDS Section Division of Disease Control and Health Protection Annual data trends as of 12/31/2014 Living (Prevalence)

Florida Department of Health HIV/AIDS Section Division of Disease Control and Health Protection Annual data trends as of 12/31/2014 Living (Prevalence)

HIV Infection Among Those with an Injection Drug Use*-Associated Risk, Florida, 2014 Florida Department of Health HIV/AIDS Section Division of Disease.

Other Sexually Transmitted Diseases Sexually Transmitted Disease Surveillance 2009 Division of STD Prevention.

This presentation is intended for educational use only, and does not in any way constitute medical consultation or advice related to any specific patient.

Epidemiology of HIV Among Asians and Pacific Islanders Reported in Florida, Through 2012 Florida Department of Health HIV/AIDS and Hepatitis Section Division.

CD4 trajectory among HIV positive patients receiving HAART in a large East African HIV care centre Agnes N. Kiragga 1, Beverly Musick 2 Ronald Bosch, Ann.

138 th American Public Health Association Annual Meeting Denver, Colorado November 8, 2010 Determinants of HIV Testing Among High School Students with.

HIV Infection Increases Risk of ASCUS and Subsequent Development of SILs Slideset on: Duerr A, Paramsothy P, Jamieson DJ, et al. Effect of HIV infection.

Henry Masur, MD Bethesda, Maryland

CONCLUSIONS New Jersey’s Emergency Department HIV testing sites report higher seroprevalence than non-ED testing sites. Since University Hospital began.

By Beshair Nurhussien, Agnes Nantambi, and Allison Wood

Seroprevalence, prevalence, type and factors associated with HPV infection at multiple sites in young HIV-positive MSM On behalf of the HPV MAPS Research.

Earlier treatment and lower mortality in infants Initiating ART at

Pediatrics HIV/AIDS and PMTCT research in Barbados: lessons learned for monitoring the epidemic and evaluating the interventions. ALOK KUMAR, MD. Lecturer.

Co-infection of STIs with HIV among men who have sex with men (MSM) in Beijing, China Xiaoyan Zhang State Key Laboratory for Infectious Disease Prevention.

Factors Associated with Low Bone Mineral Density (BMD) in a Large Cohort of HIV-Infected U.S. Adults – Baseline Results from the SUN Study # 836 ET Overton1,

Martin Goldberg1, Daniel R. Newman2, TA Peterman2,

Dorina Onoya1, Tembeka Sineke1, Alana Brennan1,2, Matt Fox1,2

Poster WP41; Contact: David A. Katz,

MSM Attending STD Clinics HIV Testing More Frequently: Implications for HIV Prevention and Surveillance D Helms1, H Weinstock1, K Mahle1, A Shahkolahi1,2,

Khai Hoan Tram, Jane O’Halloran, Rachel Presti, Jeffrey Atkinson

Presentation transcript:

Anal and Cervical Cytologic Abnormalities among HIV-Infected Women on HAART Remain Prevalent at 12 months in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN Study) Erna Milunka Kojic, Susan Cu-Uvin, Lois Conley, Tim Bush, Elizabeth R. Unger, Keith Henry, John Hammer, E. Turner Overton, Teresa Darragh, John T. Brooks The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy

Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN) 5-year prospective observational cohort study 682 adults at 7 clinics in 4 U.S. cities HAART only or no treatment for HIV Monitor complications of treatment and prolonged survival, morbidity and mortality related to HIV infection Testing at baseline and every six months, including anal and cervical HPV typing and cytology Providence Minneapolis St. Louis Denver

Demographics (n =53 on HAART) Age, years: mean (range)39 (23-59) Race/Ethnicity: n (%) White, non-Hispanic17 (32) Black, non-Hispanic27 (51) Hispanic6 (11) Other/unknown3 ( 6) Nadir CD4 cell count (cells/µl) 171 Baseline CD4 cell count (cells/µl) 465 Hormonal birth control history32 (60) Smoking, history27 (51) Smoking current22 (42)

HPV Prevalence p < 0.001

Cytology Prevalence (n =53 on HAART) Cervical cytology N=53 Anal cytology N=53 Baseline cytology Baseline n (%) 12 month n (%) Baseline n (%) 12 month n (%) Normal 38 (72)35 (66) 36 (68) Abnormal 15 (28) 18 (34) 17 (32) 22 women had abnormal cervical cytologies at baseline or 12 months 24 women had abnormal anal cytologies at baseline or 12 months

Cytology (n =53 on HAART) Anus 12 months Cervix baseline Cervix 12 months Anus Anus baseline Cervix

Cytology Persistence (n =53 on HAART) 12 Month cervical cytology N=53 12 Month anal cytology N=53 Baseline cytology NormalAbnormalNormalAbnormal Normal27/3871%11/3829%26/3574%9/3526% Abnormal8/1553%7/15 47% 10/1856%8/18 44%

HPV and Anal Sex Risk for Detection of Prevalent HPV At baseline, history of any anal sex was reported by 36 (40%) women No significant difference between women reporting a history of anal sex compared with women who did not Any HPV detected Self – reported anal sex p-value YesNo Anal HPV+86%89%0.73 Cervical HPV+79%86%0.54

Conclusions In HIV-infected women on HAART, HPV infection of the anus and the cervix remains prevalent In this cohort of HIV-infected women on HAART, about one-third had abnormal cytology in the cervix and anus at both baseline and 12 months Almost half of the women with abnormal anal and cervical cytology at baseline remained abnormal at 12 months There is no difference in HPV-related cytologic abnormalities between women who report a history of anal sex and those who do not There is a need to further elucidate the clinical significance of anal HPV infection in HIV infected women

SUN Study Sites and Laboratories CDC/ Division of HIV/AIDS Prevention John T. Brooks Lois Conley Tim Bush Cerner Corporation Kathleen Wood Rose Baker Cheryl Lapierre Hennepin County Medical Center (Minneapolis) Keith Henry Ellen Kane Abbott-Northwestern Hospital (Minneapolis) Frank Rhame Jenny Dahlke Brian Goodroad Park-Nicollet Institute (Minneapolis) Hal Martin Meaghan Morton Miriam Hospital (Providence) Charles Carpenter Susan Cu-Uvin Kenneth Mayer Milu Kojic Jennifer Florczyc Washington University School of Medicine (St. Louis) Kristin Mondy E. Turner Overton Lisa Kessels Denver Infectious Disease Consultants (Denver) John Hammer Barbara Widick Cheryl Stewart Sarah Kressy University of Colorado Health Science Center ( Denver) Kenneth Lichtenstein CDC/ Division of Viral and Rickettsial Diseases Elizabeth Unger Ruth Ann Tucker Kara Duncan David Swan

END

Inclusion Criteria  Documented HIV infection  Age > 18 years  Attended > 2 consecutive visits at clinic in the preceding year  Expected to receive care at clinic for > 2 years  Limited antiretroviral (ARV) exposure:  If < 30 days total prior ARV exposure CD  If > 30 days total prior ARV exposure Only received HAART and only since July 1, 1997 CD4 > 100

Most Prevalent High-Risk HPV Types in Anus and Cervix at Baseline Percent High-risk HPV types

Most Prevalent High-Risk HPV Types in Anus and Cervix at 12 Months Percent High-risk HPV types