Prevalence and predictors of abnormal Papanicolaou smears in HIV-infected women

Purpose of investigation: To characterize the risk factors for abnormal cervical cytology among women with human immunodeficiency virus (HIV), and to determine the relationship between antiretroviral therapy (ART) and cytology results. Materials and Methods: Retrospective study of clinical data of 115 HIV-infected women between January 2008 and December 2011. Analysis of cervical smears history, as well as, epidemiologic, medical, and sexual factors, administration of ART, CD4 cells count, and HIV viral load were performed. Results: Mean age was 35.9 ± 6.5 years. Average time of HIV infection was 10.5 ± 4.5 years. HPV infection prevalence was 37.4%, the majority was high-risk. An abnormal Papanicolaou smear was found in 43.5%. Atypical squamous cell of undetermined significance (ASC-US) was reported in 7.8%, low-grade squamous intraepithelial lesions (LSIL) in 32.2%, and high-grade squamous intraepithelial lesions (HSIL) in 3.5%. HPV infection was the only statistical predictor of abnormal cytology (p < 0.001; OR = 0.042). ART, CD4 cells count, and HIV viral load did not correlate to regression of abnormal cytology. Conclusion: These women should be followed-up according to current cervical cancer screening guidelines, independently of the therapy, CD4 cells count, and HIV viral load.

HIV-infected women; Cytology; Human papillomavirus (HPV); Predictors.

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