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Title: Lower genital tract neoplasia in women infected with the human immuno-deficiency virus
Author: Smith, James Richard
Awarding Body: University of Glasgow
Current Institution: University of Glasgow
Date of Award: 1992
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This thesis is an account of studies designed to test the hypothesis that Human Immunodeficiency virus (HIV) infection in women predisposes to the development of cervical intraepithelial neoplasia (CIN) by allowing the unchecked action of oncogenic viruses. Fifty HIV seropostive women, for 43 of whom there were HIV seronegative case matched controls were studied by cytology, colposcopy, and histology. Investigations were carried out to detect the presence of oncogenic viruses Human Papilloma virus (HPV), Epstein Barr virus (EBV) and Herpes Simplex virus (HSV). A secondary hypothesis, that the development of CIN is related to immunosuppression was tested at both a systemic and local level. At a local level immune function was investigated by measuring the Langerhans' cell number, and relating it to the presence or absence of CIN and to generalised immunosuppression. There was no significant difference in the prevalence of CIN (6/43 (14% (95% Confidence Interval: 5-28%)) versus 4/43 (9% (95% Confidence Interval: 3-28%))) or detectable cervical infection with oncogenic viruses between HIV seropositive and HIV seronegative patients. However, if the HIV infected women showed signs of immunosupression, as detected clinically, or measured by T4 count, beta 2 microglobulin, and p24 antigen the incidence of CIN was increased. An association between depressed local cervical epithelial immunity and HIV related immunosuppression was demonstrated, but this was not shown to be related to CIN. In this study HIV infection per se did not appear to increase significantly the risk of CIN developing, but immunosuppression as a HIV infection did increase this risk.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available