Observational studyJournal of acquired immune deficiency syndromes (1999)2020
Association Between CD4 Count and Chemoradiation Therapy Outcomes Among Cervical Cancer Patients With HIV.
Observational study in Journal of acquired immune deficiency syndromes (1999), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Impact of Antiretroviral Therapy (ART) on HPV Persistence and Cervical Cancer Progression Among Women with HPV/HIV Co-infection: A Systematic Review.AIDS and behavior · 2025Pooled it
- Access to Radiation Therapy and Related Clinical Outcomes in Patients With Cervical and Breast Cancer Across Sub-Saharan Africa: A Systematic Review.JCO global oncology · 2023Pooled it
- HPV genotype distribution and risk factors for cervical dysplasia among HPV-positive women with or without HIV infection in Shanghai, China.BMC infectious diseases · 2026Article
- Review
- Epidemiology and survival outcomes of HIV-associated cervical cancer in Nigeria.Infectious agents and cancer · 2023Article
- Patient perspectives on delays in cervical cancer screening and follow-up care in Botswana: a mixed methods study.BMC women's health · 2022Article
- Epidemiology of Cervical Adenocarcinoma and Squamous Cell Carcinoma Among Women Living With Human Immunodeficiency Virus Compared With the General Population in the United States.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Cervical cancer prevention and control in women living with human immunodeficiency virus.CA: a cancer journal for clinicians · 2021Review
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Authors and funding
10 authors.
Funding
Abstract
backgroundIn Botswana, nearly two-thirds of cervical cancer patients are HIV-positive. This study examined the relationship between CD4 count and chemoradiation therapy outcomes among cervical cancer patients with HIV.
settingA prospective cohort study of 231 HIV-positive women with locally invasive cervical cancer was conducted in Gaborone, Botswana from January 2015 to February 2018.
methodsPrimary outcome was survival, defined as time from scheduled end of chemoradiation therapy to death or last contact with patient. Nadir CD4 count was defined as lowest CD4 available before cancer diagnosis. Delta CD4 count was defined as improvement from nadir CD4 to CD4 at cancer diagnosis. Hazard ratio (HR) analyses were adjusted for presenting variables (age, baseline hemoglobin, cancer stage, and performance status) and treatment variables (chemotherapy cycles and radiation dose).
resultsTwo hundred thirty-one patients were included in nadir CD4 analysis; 139 were included in delta CD4 analysis. Higher delta CD4 was significantly associated with reduced mortality after adjusting for presenting and treatment variables (CD4 100-249: HR 0.45, 95% CI: 0.21 to 0.95; CD4 ≥250: HR 0.45, 95% CI: 0.20 to 1.02). Higher nadir CD4 showed a trend toward reduced mortality after adjusting for presenting and treatment variables (HR 0.94, 95% CI: 0.84 to 1.06).
conclusionsHigher delta CD4 (greater improvement from nadir CD4 to CD4 at cervical cancer diagnosis) is significantly associated with lower mortality. Although not statistically significant, data suggest that higher nadir CD4 may reduce mortality. These results reinforce the importance of early HIV diagnosis and antiretroviral therapy initiation, as their effects influence cervical cancer outcomes years later.
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