Prevalence of Adenomas Found on Colonoscopy in Patients With HIV (original) (raw)
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Clinical colorectal cancer, 2009
Patients infected with Human immunodeficiency virus (HIV) living longer with antiretroviral therapy (ART) are more likely to develop non-AIDS-defining cancers such as adenocarcinoma of the colon. There have been limited case reports regarding HIV-associated colon adenocarcinoma. The aim of this study was to characterize the clinicopathologic findings and outcome in a series of HIV-infected patients diagnosed and treated for colon adenocarcinoma. A retrospective study involving HIV-related colon adenocarcinoma was performed. Cases were accrued from the personal archives and published case reports. Data regarding demographics, HIV acquisition, ART use, immunosuppression, cancer location, pathology, and outcome were extracted and analyzed. A total of 17 patients were identified, including 7 personal cases. Patients were of average age 43 years (range, 25-67 years) and predominantly male (male:female ratio, 14:3). Most carcinomas (57%) involved the right colon, were largely TNM stage 4 ...
HIV Medicine, 2014
Objectives-The aim of the study was to estimate the cumulative incidence of, and rates of progression to, invasive anal cancer (IAC) according to baseline anal cytology screening category in an unselected HIV clinical care cohort in the antiretroviral era. Methods-A retrospective cohort analysis of HIV-infected patients under care at the University of California at San Diego Owen Clinic was carried out. Patients were eligible for this analysis if they had at least two anal cytohistological results available for longitudinal analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of IAC over time according to baseline cytology category [less than high-grade intraepithelial lesion (HSIL) versus HSIL]. Cox regression analysis was used to adjust for the following covariates: antiretroviral use, level of HIV viraemia, smoking status and infrared photocoagulation (IRC) ablation therapy. Results-Between 2000 and 2012, we followed 2804 HIV-infected patients for a median of 4 years under a clinic protocol requiring baseline anal cytology screening. Incident IAC was diagnosed in 23 patients. Patients with a baseline HSIL anal cytology had an estimated 5-year probability of progression to IAC of 1.7% and an estimated annual progression risk of 1 in 263. None of the examined covariates was significantly associated with IAC incidence when examined in separate unadjusted Cox models. Conclusions-HIV-infected patients with a baseline HSIL anal cytology had a 5-year cumulative incidence of IAC of 1.65%, with an upper 95% confidence bound of 4.5%. This population-based study provides quantitative risk estimates that may be used for counselling patients regarding management options for abnormal cytology results.
Incidence of Adenoid Hypertrophy in HIV Infected Individuals at a Tertiary Care Hospital
2017
Mathews Journal of HIV/AIDS Incidence of Adenoid Hypertrophy in HIV Infected Individuals at a Tertiary Care Hospital Arpit Saxena1, Sonam Saxena2 1Senior Resident, Department of Otorhinolaryngology, UPRIMS & R, Saifai, Etawah, UP, India. 2Medical Officer, Department of Otorhinolaryngology, UPRIMS & R, Saifai, Etawah, UP, India. Corresponding Author: Arpit Saxena, Senior Resident, Department of Otorhinolaryngology, UPRIMS & R, Saifai, Etawah, UP, India. Tel: +91-9532306179; Email: arpitsaxenaexam@gmail.com
The Journal of Infectious Diseases, 2010
Background. The prevalence of and risk factors for abnormal anal cytology among men and women with human immunodeficiency virus (HIV) infection have not been extensively investigated. Methods. The Study to Understand the Natural History of HIV and AIDS in the Era of Effective Therapy (SUN study) is a prospective cohort study of HIV-infected patients in 4 US cities. Baseline questionnaires were administered and anal samples for cytology and human papillomavirus (HPV) detection and genotyping were collected. Results. Among 471 men and 150 women (median age, 41 years), 78% of participants were receiving combination antiretroviral therapy, 41% had a CD4 + cell count of у500 cells/mL, and 71% had an HIV RNA viral load of !400 copies/mL. The anal cytology results were as follows: 336 participants (54%) had negative results, 96 participants (15%) had atypical squamous cells, 149 participants (24%) had low-grade squamous intraepithelial lesions, and 40 participants (6%) had high-grade squamous intraepithelial lesions. In a multivariate analysis, abnormal anal cytology was associated with number of high-risk and low-risk HPV types (adjusted odds ratio [AOR] for both, 1.28;), nadir CD4 + cell count of !50 cells/mL (AOR, 2.38;), baseline CD4 + cell P ! .001 P p .001 count of !500 cells/mL (AOR, 1.75;), and ever having receptive anal intercourse (AOR, 2.51;). P p .004 P ! .001 Conclusion. HIV-infected persons with multiple anal HPV types or a nadir CD4 + cell count of !50 cells/mL have an increased risk for abnormal anal cytology.
Journal of Gastrointestinal Oncology, 2016
Background: Limited knowledge exists about the effects chronic hepatitis C virus (HCV) infection has in the development of colorectal adenomas (CRA). Data regarding the association between chronic HIV infection and the development of CRA is scarce as well. We aim to determine if there is an association between the development of CRA and chronic infection with HCV and HCV/HIV co-infection. Methods: From July 1, 2009 to March 31, 2011 a total of 2,051 patients that underwent colonoscopy were included in our study. The population was divided into 2 study groups: those patients who tested positive for HCV, and HCV/HIC; the control groups consisted of patients whose results were negative. Fisher's exact χ 2 test for categorical variables and t-test for continuous variables was used to analyze data between groups. Logistic regression was performed to obtain odds ratios (OR). Results: CRA detection was higher in the HCV than in the control group (26.3% vs. 20.2%; P=1.02); Likewise, the incidence of CRA (25.5% vs. 20.8%; P=0.63) was higher in the co-infection group. However, in both of the study groups this difference was non-statistical. Conclusions: A higher detection rate of CRP was seen in the HCV population; however, it failed to reach statistical significance. Whether co-infection with HIV/HCV increases the incidence of CRA and/ or has a synergistic effect remains to be determined. The small sample population and the retrospective single institution nature of our study, as well as other confounders may have contributed to our negative results. However, our findings question whether HCV and HIV/HCV co-infected patients will benefit from screening colonoscopy at an earlier age. This issue merits further investigation with a large multi-center prospective study.
Journal of Infectious Diseases, 2015
Background. Anal cancer rates are higher for human immunodeficiency virus (HIV)-infected adults than for uninfected adults. Limited published data exist characterizing the incidence of precursor lesions detected by anal cytology. Methods. The Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy was a prospective cohort of 700 HIV-infected participants in 4 US cities. At baseline and annually thereafter, each participant completed a behavioral questionnaire, and healthcare professionals collected anorectal swabs for cytologic examination and human papillomavirus (HPV) detection and genotyping. Results. Among 243 participants with negative baseline results of anal cytology, 37% developed abnormal cytology findings (incidence rate, 13.9 cases/100 person-years of follow-up; 95% confidence interval [CI], 11.3-16.9) over a median follow-up duration of 2.1 years. Rates among men having sex with men, among women, and among men having sex with women were 17.9 cases/personyears of follow-up (95% CI, 13.9-22.7), 9.4 cases/person-years of follow-up (95% CI, 5.6-14.9), and 8.9 cases/person-years of followup (95% CI, 4.8-15.6), respectively. In multivariable analysis, the number of persistent high-risk HPV types (adjusted hazard ratio [aHR], 1.17; 95% CI, 1.01-1.36), persistent high-risk HPV types except 16 or 18 (aHR, 2.46; 95% CI, 1.31-4.60), and persistent types 16 or 18 (aHR, 3.90; 95% CI, 1.78-8.54) remained associated with incident abnormalities. Conclusions. The incidence of abnormal anal cytology findings was high and more likely to develop among persons with persistent high-risk HPV.
Journal of Infectious Diseases, 2015
Background. Anal cancer rates are higher for human immunodeficiency virus (HIV)-infected adults than for uninfected adults. Limited published data exist characterizing the incidence of precursor lesions detected by anal cytology. Methods. The Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy was a prospective cohort of 700 HIV-infected participants in 4 US cities. At baseline and annually thereafter, each participant completed a behavioral questionnaire, and healthcare professionals collected anorectal swabs for cytologic examination and human papillomavirus (HPV) detection and genotyping. Results. Among 243 participants with negative baseline results of anal cytology, 37% developed abnormal cytology findings (incidence rate, 13.9 cases/100 person-years of follow-up; 95% confidence interval [CI], 11.3-16.9) over a median follow-up duration of 2.1 years. Rates among men having sex with men, among women, and among men having sex with women were 17.9 cases/personyears of follow-up (95% CI, 13.9-22.7), 9.4 cases/person-years of follow-up (95% CI, 5.6-14.9), and 8.9 cases/person-years of followup (95% CI, 4.8-15.6), respectively. In multivariable analysis, the number of persistent high-risk HPV types (adjusted hazard ratio [aHR], 1.17; 95% CI, 1.01-1.36), persistent high-risk HPV types except 16 or 18 (aHR, 2.46; 95% CI, 1.31-4.60), and persistent types 16 or 18 (aHR, 3.90; 95% CI, 1.78-8.54) remained associated with incident abnormalities. Conclusions. The incidence of abnormal anal cytology findings was high and more likely to develop among persons with persistent high-risk HPV.