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HIV Infection and Pre-Cancerous Cervical Lesion among Women in Ethiopia: A Systemic Review and Meta-Analysis

Abiyu Ayalew Assefa, Kaleab Tesfaye Tegegne, Eleni Tesfaye Tegegne, Mekibib Kassa Tessema, Geleta Abera Gemeda, Getnet Tafese Walesa, Demelash Zeleke Berga

Background: Cervical cancer is the second most prevalent cancer among women in the developing countries including Ethiopia. Precancerous lesions can be developed and risk to the development of cervical cancer over time. Early identification of the precancerous lesion and its risk factor is paramount in preventing cervical cancer.

Objective: The aim of this study was to determine the impact of HIV status on pre-cancerous cervical lesions.

Methods: Searches were carried out in Pub Med, Google Scholar, web of science and Scopus. Studies were selected for meta-analysis if they reported the number of pre-cancerous cervical lesion, according to HIV status. For critical appraisal of studies, Newcastle-Ottawa Quality Assessment Scale (NOS) was used. The analysis was conducted by using meta-essential and Revman software. To test the heterogeneity of studies, the Cochran Q test and I2 test statistics were used. To detect publication bias of the studies, the funnel plot and Egger’s test were used. The pooled prevalence of cervical cancer screening and the odds ratio (OR) with a 95% confidence interval was presented using forest plots.

Results: Overall, 9 of 360 records identified through database searching met inclusion criteria. The pooled adjusted odds ratios for pre-cancerous cervical lesion comparing Women who are HIV positive versus Women who are HIV negative was OR 1.75 (95% CI: 1.40, 2.18), P<0.00001, I2=0%).

Conclusion: These findings support the hypothesis that being HIV positive has a marked effect on PCC L and the risk of PCCL. Government and other stakeholders should give high priority in early screening of cervical cancer for patients living with HIV.s.