Der Einfluss der Humanen Papilloma Virus Infektion auf die Entwicklung von intraepithelialen Läsionen der Zervix bei Frauen mit und ohne Infektion mit dem Humanen Immundefizienz Virus in Tansania

Judick, Mona (2025): Der Einfluss der Humanen Papilloma Virus Infektion auf die Entwicklung von intraepithelialen Läsionen der Zervix bei Frauen mit und ohne Infektion mit dem Humanen Immundefizienz Virus in Tansania. Dissertation, LMU München: Medizinische Fakultät

Abstract

Objective: The 2H study (2H for human papilloma virus – HPV – and human immu-nodeficiency virus – HIV) conducted a cervical carcinoma screening with follow up of women in the southwestern region of Tanzania. One part of the study, the assessment of courses of HPV infections and their associations with pathological observations of the cervix, is subject to this text. Introduction: HPV infections are the most common sexually transmitted diseases in the world. If persistent, a high-risk HPV (HR-HPV) infection can lead to the develop-ment of cervical cancer. Tanzania is among the countries with the highest rates of cer-vical cancer. Measures of prevention like vaccination campaigns of teenagers are only slowly and infrequently being started. Systematic screening remains scarce. The re-spective region of Tanzania also has the highest burden of HIV infections in the coun-try. HPV und HIV coinfection stays a frequent subject of studies due to their sweeping consequences. HIV positive women have a higher risk to develop cervical cancer in their lifespan. Methods: Roll-out of a yearly gynecological screening in Mbeya region, Tanzania. Enrolment to the study follows a pathological swap or by chance with normal histo-cytology. HPV genotyping and examination of cervical specimen were taking place over several years. Subsequently, analyses of HPV courses and their association with pathologies of the cervix were done. Results: The 2H Study examined 857 women on yearly appointments for up to six years. Most prevalent HR-HPV in the follow up period were subtypes 16, 18, 35, and 58. HIV-positive women had more HPV infections, more co-infections, more persis-tent infections, but also more infections which cleared, less interventions and more pathological findings of the cervix. Three HIV-negative women and six HIV-positive women developed cervical carcinoma over the course of the study. Conclusion: HIV-positive women are in need of special attention regarding gyneco-logical screening. However, HIV-negative women would just as much profit from a systematic approach to cervical carcinoma screening in Tanzania, foremost until vac-cination campaigns can show their effect.

• Dokumententyp: Dissertationen (Dissertation, LMU München)
• Keywords: HPV, HIV, Zervixkarzinom, Tansania
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften ; 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• Fakultäten: Medizinische Fakultät
• Sprache der Hochschulschrift: Deutsch
• Datum der mündlichen Prüfung: 27. Februar 2025
• 1. Bericht­erstatter:in: Hoelscher, Michael