Association between viral load and CD4+ T lymphocyte count and cervical intraepithelial lesions in HIV-infected women - Revista Brasileira de Ginecologia e Obstetrícia

Association between viral load and CD4+ T lymphocyte count and cervical intraepithelial lesions in HIV-infected women |

PURPOSE: to evaluate CD4+ T lymphocyte cell count and HIV viral load influence on the presence of cervical squamous intraepithelial lesions (SIL). METHODS: cross-sectional study of 134 HIV-infected women submitted to uterine cervical biopsy, HIV viral load quantification and CD4+ T lymphocyte cell count. Viral load and CD4+ T lymphocyte cell count were performed before biopsy timing. Three different levels of viral load (<400 copies/mL; 401 to 50,000 copies/mL; >50,000 copies/mL) and CD4+ T lymphocyte count (<200 cells/mm³; 200 to 350 cells/mm³; >350 cells/mm³) were defined. Data were statistically analyzed by the chi2 test, linear tendency chi2 test, Mantel-Haenszel test, and analysis of variance, with level of significance set at p<0.05 and 95% confidence interval. RESULTS: there was no risk tendency for HIV-infected women to show SIL with viral load level increase or CD4+ T lymphocyte reduction. Comparing viral load with the presence or absence of SIL, stratified by quantification timing, there was a significant difference for values over 400 copies/mL (p=0.048; OR: 3.17; 95% CI: 1,02-9.93). No association was found between CD4+ T lymphocyte cell count and SIL. CONCLUSION: patients with HIV viral load higher than 400 copies/mL, performed before uterine cervical biopsy, showed a 3.17 times greater chance to develop SIL. CD4+ T lymphocyte count had no influence on the development of SIL.