{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:29:10Z","timestamp":1792592950167,"version":"4.5.0"},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,3,11]],"date-time":"2020-03-11T00:00:00Z","timestamp":1583884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We evaluated the association of antiretroviral therapy (ART), CD4+ count and human immunodeficiency virus (HIV) plasma viral load (PVL) on high-grade cervical intraepithelial neoplasia (CIN2+) detection at follow-up after CIN management among women living with HIV (WLHIV).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Medline, Embase, Global Health, and PubMed were searched from 1 January 1996 to 15 January 2020. Eligible studies investigated the association of ART, CD4+ count, or HIV PVL on histology-confirmed CIN2+ detection at follow-up. Summary estimates were obtained using random-effects meta-analyses; heterogeneity was examined using I2 statistic. PROSPERO registration: CRD42018115631.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eight studies representing 9 populations were identified, including 1452 WLHIV followed between 6 and 33 months post-CIN management. Pooled data from 8 populations (n\u2005=\u20051408) suggested weak evidence of a decreased risk of CIN2+ detection at follow-up among ART users compared to ART-naive women (crude odds ratio [cOR]\u2005=\u20050.70, 95% confidence interval [CI]: .36\u20131.36; I2 = 64.5%, P\u2005=\u2005.006; adjusted risk ratio [aRR] from 3 studies\u2005=\u20050.66, 95% CI: .20\u20132.24; I2 = 78.7%, P\u2005=\u2005.009). A significant association was observed in high-income countries (cOR\u2005=\u20050.24, 95% CI: .13\u2013.45; I2 = 0.0%, P\u2005=\u2005.77) but not in low and middle-income countries (cOR\u2005=\u20051.13, 95% CI: .67\u20131.92; I2 = 18.8%, P\u2005=\u2005.30).<\/jats:p>\n                  <jats:p>In 3 populations, ART users with HIV PVL\u2005&amp;lt;50 copies\/ml were less likely to have CIN2+ detection at follow-up (vs \u226550 copies\/mL: cOR\u2005=\u20050.55, 95% CI: .32\u2013.94; I2 = 0.0%, P\u2005=\u2005.23).<\/jats:p>\n                  <jats:p>There was weak evidence of decreased CIN2+ detection at follow-up among WLHIV with higher contemporary CD4+ cell counts (\u2265200 cells\/\u00b5L vs &amp;lt;200 cells\/\u00b5L [cOR\u2005=\u20050.36, 95% CI: .04\u20133.13; I2 = 81.3%, P\u2005=\u2005.021]) and significant evidence among women with a higher nadir CD4+ count (\u2265350 cells\/\u00b5l vs &amp;lt;200 cells\/\u00b5l [adjusted hazard ratio [aHR]\u2005=\u20050.35, 95% CI: .15\u2013.84; I2 = 0%, P\u2005=\u2005.64]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>ART may reduce the risk of CIN2+ detection at follow-up; this effect is most likely enhanced by a combination of adequate HIV control and excisional CIN treatment. Our findings support recommendations of early ART and the integration of CIN2+ screening and management into HIV care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa238","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T12:33:29Z","timestamp":1583843609000},"page":"e540-e548","source":"Crossref","is-referenced-by-count":17,"title":["Antiretroviral Therapy and Detection of High-grade Cervical Intraepithelial Neoplasia (CIN2+) at Post-CIN Management Follow-up Among Women Living With Human Immunodeficiency Virus: A Systematic Review and Meta-Analysis"],"prefix":"10.1093","volume":"71","author":[{"given":"Njika","family":"Atemnkeng","sequence":"first","affiliation":[{"name":"Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abang Desmond","family":"Aji","sequence":"additional","affiliation":[{"name":"Faculty of Science, 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