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Increased regression and decreased incidence of human papillomavirus- related cervical lesions among HIV-infected women on HAART

机译：HIV感染妇女在HAART上与人乳头瘤病毒相关的宫颈病变的回归增加并降低发生率

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Objective: To determine the impact of HAART on incidence, regression, and progression of cytopathological abnormalities in HIV-infected women. Design: Prospective cohort. Methods: HIV-infected women (N=1123) from Soweto, South Africa underwent serial cervical smears that were analyzed and reported using the Bethesda System. The results of HAART and non-HAART users were compared using two statistical approaches: a survival analysis assessing risk of incident smear abnormality among women with baseline normal smear results; and analysis with marginal models assessing for an association between HAART use and likelihood of regression/progression in consecutive smears. Results: After multivariate survival analysis, women using HAART with a normal baseline smear were 38% less likely to have an incident smear abnormality during follow-up than nonusers [confidence interval (CI) 0.42-0.91; P=0.01]. Multivariate marginal models analysis identified a significantly increased likelihood (odds ratio 2.61; CI 1.75-3.89; P<0.0001) of regression of cervical lesions among women on HAART. Conclusion: Our large prospective cohort study adds significant weight to the side of the balance of clinical research supporting the positive impact of HAART on the natural history of human papillomavirus-related cervical disease in HIV-infected women.
机译：目的：确定HAART对HIV感染妇女的发病率，消退率和细胞病理学异常进展的影响。设计：预期队列。方法：南非Soweto的HIV感染妇女（N = 1123）进行了宫颈连续涂片检查，并使用Bethesda系统进行了报告。使用两种统计方法对HAART和非HAART使用者的结果进行了比较：生存分析评估基线基线涂片结果正常的女性发生涂片异常的风险;并使用边缘模型进行分析，以评估HAART使用与连续涂片中回归/进展可能性之间的关联。结果：经过多因素生存分析，使用HAART且基线涂片正常的妇女与非使用者相比，随访期间发生涂片异常的可能性要低38％[置信区间（CI）0.42-0.91; P ＝ 0.01]。多变量边际模型分析确定了接受HAART治疗的女性宫颈病变消退的可能性显着增加（几率2.61; CI 1.75-3.89; P <0.0001）。结论：我们的大规模前瞻性队列研究增加了临床研究的平衡性，从而支持了HAART对HIV感染女性中人乳头瘤病毒相关宫颈疾病的自然病程的积极影响。

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