Ferrero S, Cristoforoni P, Biasotti B, Fulcheri E, Bentivoglio G; International Conference on AIDS.
Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. B10274.
Department of Obstetrics and Gynecology University of Genova, Genova, Italy
BACKGROUND: to determine: 1) whether the pathology correlates with the degree of immunosuppression, 2) whether there is a relation between pathology and antiretroviral therapies, 3) whether Papanicolau smears correlate with colposcopic and histological findings, 4) whether there is rapid genital disease progression after standard gynaecologic care. METHODS: retrospective study. Immunologic, gynaecologic and virologic data were extracted either from patients' charts or from laboratory testing. RESULTS: at first visit Papanicolaou smears resulted normal in 43.7% of the women, 8.4% of the patients had reactive and reparative changes, 2.8% atypical cells of undetermined significance, 33.8% low-grade squamous intraepithelial lesions and 11.3% high-grade squamous intraepithelial lesions. Patients with a normal PAP smear had higher CD4 cell count (318 +/- 191 cells/microL) compared to patients with squamous intraepithelial lesions (297 +/- 116 cells/microL) but the difference was not statistically significant (Mann-Whitney test). The distribution of cervical dysplasia was found to be similar regardless of antiretroviral therapy (Chi-square analysis). The sensitivity and specificity of Papanicolaou tests for detecting CIN were 94 % and 80%. 22% of surgically treated women had persistent or recurrent disease. CONCLUSIONS: lower CD4+ cell counts are not predictive of the presence of cervical dysplasia. All HIV-infected women, independently from their immunological and clinical conditions, need regular Papanicolaou smears with appropriate follow-up for abnormal cervicovaginal cytology. We recommend that HIV-infected women have Pap annually after two initial smears, 6 months apart, have normal results. Organizing services so that gynaecologic and general care is provided at the same site appears to be one promising strategy to improve cervical cancer screening in HIV-infected women.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- Cervical Intraepithelial Neoplasia
- Female
- HIV
- HIV Infections
- HIV Seropositivity
- Humans
- Mass Screening
- Neoplasms, Squamous Cell
- Retrospective Studies
- Sensitivity and Specificity
- Uterine Cervical Dysplasia
- Vaginal Smears
Other ID:
UI: 102253250
From Meeting Abstracts