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Precancerous cervical lesions among HIV-positive women in Benin in 2017: Prevalence and determinants

Background: Precancerous lesions of the cervix are common in HIV-positive and are caused by the human papillomavirus (HPV) in 97% of cases. Despite the high rate of HIV in Benin, the proportion of cervical pre-cancer is still unknown. The objective of this study is to determine the prevalence of precancerous cervical lesions and their determinants in HIV-positive women (HPW) in Benin, West Africa, 2017.

Methods: It was a cross-sectional study conducted from September to November 2017. The study population was made of consenting HPW. Women with suspected precancerous lesions at Visual inspection with acetic acid and Lugol were given a cervical biopsy followed by a pathological examination. Data were analyzed using R software. The significance threshold used was 5%. Log-binomial regression was used to identify the determinants.

Results: Two hundred (200) women’s were included in the study. The median age was 35 years with an interquartile range (IQ) of [30.05-41.00]. All of these women were carriers of HIV 1. The median recent CD4 count was 335.65 IQ [170.50-384.66]. The prevalence of precancerous cervical lesions based on pathological examination in our study was 27%, 95%CI [24.10; 29.90]. Low-grade cervical intraepithelial neoplasia (CIN I) lesions accounted for 81.66% of cases. The determinants of the precancerous lesions found were severe immunosuppression (CD4 ≤ 200) with p=0.002 and absence of Cotrimoxazole treatment (p=0.026).

Conclusion: These results highlight the importance of severe immunosuppression in the development of precancerous cervical lesions in HPW. Early detection and better follow-up of HPW are needed.


Elfried Salanon

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