Cervical intraepithelial neoplasia and invasive cancer risks in women infected with HIV in the French West Indies.

OBJECTIVE: The aim of the study was to assess whether HIV infection is associated with a higher risk of invasive cervical cancer (ICC). METHODS: We conducted a region-wide, population-based observational cohort study of 1232 HIV-infected women over the age of 15 years in Guadeloupe, a French Caribbean archipelago, during the period 1999-2006. The observed numbers of incident cases of cervical intraepithelial neoplasia (CIN) and ICC were compared with the expected numbers of cases based on the incidence rates for the general population, and the standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. RESULTS: The incidence rate of CIN was higher in the HIV-infected women than in the general population for all grades (SIR 10.1, 95% CI 6.8-14.6 for CIN grade 1; SIR 9.9, 95% CI 6.1-15.3 for CIN grade 2; and SIR 5.2, 95% CI 3.4-7.7 for CIN grade 3). However, no increase in the risk of ICC was observed (SIR 1.7, 95% CI 0.3-4.9). CONCLUSIONS: Despite an increase in the occurrence of cervical cancer precursors, no increase in the risk of cervical cancer was found in a population of HIV-infected women who receive treatment for their infection and have access to ICC prevention services.

High prevalence of HIV infection in Saint Martin, French West Indies - abstract

Saint-Martin is a melting pot of Caribbean populations. A sharp increase of immigrant people was noted these last years, as a consequence of the booming tourism-related activity. Since no data were available on AIDS, an epidemiological study was developed. Since almost all births take place in the only hospital, hosptial-based information was considered as a reliable indicator of the development of the epidemic in the whole population. During pregnancy, or at delivery, blood samples were taken for HIV detection. Results were ready within four days. Positive results were found in 3 per cent of the women (n=54), in the years 1991 - 1993. All babies born from HIV-positive mothers were also positive. In 1991 and 1991, only a small minority of these women and their children was followed, since no appropriate structure existed. In 1993, a special clinic was instituted, and two-thirds of them could be followed. Evaluation of materno-foetal viral transmission is in process. The prevalence in Saint-Martin is estimated to be 4 times as high as in New York City, and 20 times as high as in Paris (AU)

Fibronectin and the prognosis of adverse foetal outcome in maternal hypertension: a study from a West Indian population - abstract

A single assay of maternal fibronectin level is not specific enough to predict adverse foetal outcome, but daily measurement of maternal fibronectin level and a time-relate analysis allow a good prediction of the disease. In predicting adverse foetal outcome, these measurements complement the information provided by the physical methods of evaluation of the foetal status such as Doppler, ehcography or cardiotocography. The daily profile of plasma fibronectin level during hypertensive pregnancies shows a bi-phasic pattern: an early increase in fibronectin is followed by a decrease or at least a plateau preceding delivery. This last observation is consistent with a protective role of fibronectin as emphasised by Frolich and Bathia (AU)

[Thermolabile fraction of amniotic alkaline phosphatase and fetal lung maturity]. / Fraction thermolabile de la phosphatase alcaline amniotique et maturité pulmonaire foetale.

In order to predict respiratory distress syndrome (RDS) in the newborn due to the lack of surfactant, we measured the change in the total and heat labile fraction of alkaline phosphatase (ALP) in amniotic fluid obtained at various gestational ages. Heat labile alkaline phosphatase increased both absolutely and in relation to total ALP from 32 weeks to term. We have used the ratio heat labile ALP/total ALP to predict lung maturity. There was no respiratory distress in infants born after the heat labile ALP/total ALP in the amniotic fluid was above 0.7. The assay is technically easy so that measurement of this ratio should help predict which infant will develop RDS.

The Activity of heat-labile fraction of alkaline phosphatase in amniotic fluid as a predictive value for lung maturity - abstract

In order to predict respiratory distress syndrome in the newborn due to lack of lung surfactant, we measured the change in the total and heat-labile fraction of alkaline phosphatase(AP) in amniotic fluid obtained from amniocentesis at various gestational ages. Heat-labile alkaline phosphatate increased both absolutely and in relation to total alkaline phosphatase from 32 weeks to term. Over the past two years, we have used the ratio heat-labile AP/total AP to predict lung maturity. There was no respiratory distress in infants born after the heat-labile AP/total AP in the amniotic fluid was above 0.7. The assay is technically easy so that measurement of this ratio should help predict which infants will develop respiratory distress syndrome (AU)