Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

HPV testing in HIV-positive women may help reduce frequent cervical cancer screening

23.07.2012
Compared to the general population, HIV-positive women have a high risk of cervical cancer and thus are advised to undergo more frequent screening tests. This creates a burden for HIV-positive patients and the health care system, leading to frequent biopsies, which often do not reveal clinically relevant disease.

A new study by researchers at Albert Einstein College of Medicine of Yeshiva University suggests that HIV-positive women may be able to use new methods that can help to safely reduce the frequency of screening in some women, similar to practices accepted in the general population. The findings will be published in the July 25 issue of the Journal of the American Medical Association (JAMA), a theme issue on HIV/AIDS.

Howard Strickler, M.D., M.P.H. professor of epidemiology and population health at Einstein and senior author of the study, presented the findings today at a JAMA media briefing at the International AIDS Conference.

As of 2009, 1.2 million people age 13 and older were living with HIV in the United States, according to the Centers for Disease Control and PreventionWomen accounted for about one-quarter of those infected.

In March 2012, the United States Preventive Services Task Force revised its cervical cancer screening guidelines for HIV-negative women aged 30 or older to once every five years from once every three years provided they have a normal Pap smear test and a negative test for human papillomavirus (HPV), the virus mainly responsible for cervical cancer. The Pap test detects precancerous or cancerous changes in the cervical lining and the HPV test detects cancer-associated types of the virus.

But those guidelines did not update screening recommendations for HIV-positive women. Current recommendations for HIV-positive women are to have two Pap tests, at six-month intervals, in the first year following diagnosis of HIV and, if normal, on an annual basis from then on. HPV testing is not currently recommended for HIV-positive women.

The current study looked at whether cervical cancer screening could be reduced in HIV-positive women who have a normal Pap test and a negative test for HPV. The Einstein researchers reasoned that for women with a normal Pap test and no evidence of cervical HPV infection, the risk of cervical precancer or cancer is likely to be very low for several years regardless of HIV status.

“It is widely thought that before cervical precancer or cervical cancer can develop, there must be persistent infection by a cancer-associated HPV, as well as the accumulation of additional genetic changes over time,” said Dr. Strickler.

The study analyzed data on 420 HIV-positive and 279 HIV-negative women who were enrolled in the Women’s Interagency HIV Study (WIHS), the largest prospective study of HIV-positive women in the US. (Montefiore Medical Center, the University Hospital for Einstein, is one of the six clinical sites for WIHS.) At enrollment, each woman had a normal Pap test and tested negative for the cancer-related HPV types. The women’s rates of cervical precancer and cancer were measured after three- and five-years of follow-up.
At both the three- and five-year screening intervals, the incidence of cervical precancer was found to be similar in both HIV-positive and HIV-negative women. No cases of cervical cancer were detected in either group.

“Overall, few cases of cervical precancer would have gone undiagnosed if the HIV-positive women did not have any additional Pap tests during the five years following enrollment — no more than in the HIV-negative group,” said lead author Marla Keller, M.D., associate professor of medicine and of obstetrics & gynecology and women’s health at Einstein and attending physician, medicine at Montefiore. “Thus, these data raise the possibility that HPV and Pap co-testing could be used to reduce the burden of frequent Pap tests and, by extension, unnecessary biopsies in HIV-positive women who are in long-term clinical follow-up.”
Other contributors include Robert Burk, M.D.; Xianhong Xie, Ph.D.; Kathryn Anastos, M.D.; and Xiaonan Xue, Ph.D., all at Einstein; L. Stewart Massad, M.D. (Washington University School of Medicine, St. Louis, MO); Howard Minkoff, M.D. (Maimonides Medical Center, Brooklyn, NY); Gypsyamber D’Souza, Ph.D. (Johns Hopkins Bloomberg School of Public Health, Baltimore, MD); D. Heather Watts, M.D. (National Institute of Child Health and Human Development, Bethesda, MD); Alexandra Levine, M.D. (City of Hope National Medical Center, Duarte, CA); Philip Castle, Ph.D. (American Society for Clinical Pathology, Washington, DC); Christine Colie, M.D. (Georgetown University Medical Center, Washington, DC); and Joel Palefsky, M.D. (University of Southern California, San Francisco, CA).

The study was funded by several grants from the National Institutes of Health, including from the National Cancer Institute (CA085178), the National Institute of Allergy and Infectious Diseases (AI079763 and AI51519), the Eunice Kennedy Shriver National Institute of Child Health & Human Development (HD32632), and the National Center for Research Resources (RR024131 and RR025750).

About Albert Einstein College of Medicine of Yeshiva University
Albert Einstein College of Medicine of Yeshiva University is one of the nation’s premier centers for research, medical education and clinical investigation. During the 2011-2012 academic year, Einstein is home to 724 M.D. students, 248 Ph.D. students, 117 students in the combined M.D./Ph.D. program, and 368 postdoctoral research fellows. The College of Medicine has 2,522 full time faculty members located on the main campus and at its clinical affiliates. In 2011, Einstein received nearly $170 million in awards from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Its partnership with Montefiore Medical Center, the University Hospital and academic medical center for Einstein, advances clinical and translational research to accelerate the pace at which new discoveries become the treatments and therapies that benefit patients. Through its extensive affiliation network involving Montefiore, Jacobi Medical Center) – Einstein’s founding hospital, and five other hospital systems in the Bronx, Manhattan, Long Island and Brooklyn, Einstein runs one of the largest post-graduate medical training programs in the United States, offering approximately 155 residency programs to more than 2,200 physicians in training. For more information, please visit www.einstein.yu.edu and follow us on Twitter @EinsteinMed.

Kim Newman | EurekAlert!
Further information:
http://www.einstein.yu.edu

More articles from Health and Medicine:

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

nachricht The gut microbiota plays a key role in treatment with classic diabetes medication
01.06.2017 | University of Gothenburg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Quantum thermometer or optical refrigerator?

23.06.2017 | Physics and Astronomy

A 100-year-old physics problem has been solved at EPFL

23.06.2017 | Physics and Astronomy

Equipping form with function

23.06.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>