DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160584

Comparative study of Pap smear abnormalities in HIV infected and HIV non-infected women

Kusumam V. N., Naseema Beevi A., Smitha Sreenivas, Nurul Ameen A. M., Vidya R. Menon

Abstract


Background: HIV positive women are more likely than HIV negative women to have cervical dysplasia. Incidence of HPV-related dysplasia increases as immune function declines. To analyse the prevalence of cervical dysplasia on papsmear among women affected with HIV and to compare with that of HIV negative women.

Methods: The study period was of 6 months duration from December 2010 to May 2011. Cervical cytology specimen from HIV positive and HIV negative women who attended the OPD of Institute of Maternal and Child Health, Government Medical College, Kozhikode. Were collected after excluding known case of carcinoma cervix, post hysterectomy patients, patients with bleeding per vagina and also those with active genital tract infections.

Results: A prospective study of 200 females (100 HIV positive and 100 HIV negative) was done in our hospital. Age range was between 36 and 50 years. PAP smear abnormality was obtained in 35% of the study group. Out of which 21% was seen in HIV positive patients and 14% in HIV negative patients. Prevalence of LSIL (low grade squamous intraepithelial lesion) was significantly higher among HIV positive patients. Abnormality was not associated with CD4 count, HIV status of husband or addictions of husband, not associated with number of partners of husband both in HIV positive and negative patients.

Conclusions: PAP smear abnormality (overall), prevalence of LSIL was significantly higher among HIV positive patients. It was not associated with SES, age of first intercourse, number of partners of wife and other immunosuppressive status.

Keywords


PAP smear abnormalities, HIV infection, Cervical dysplasia

Full Text:

PDF

References


Berek JS. Intraepithelial Disease of Cervix, vagina and vulva. Berek and Novak’s Gynaecology: 14th edition. 2014:562-89.

Pund ER, Nieburgs H, Nettles JB. Preinvasive carcinoma of the cervix uteri. Arch Pathol Lab Med 1947;44:571-7.

American College of Obstetricians and Gynecologists. Cervical cytology screening. ACOG Practice Bulletin. Number 45, August 2003. Int J Gynaecol Obstet. 2003.

ASCUS-LSIL Triage Study (ALTS) Group. Results of a randomized trial on the management of cytology interpretations of atypical squamous cell of undetermined significance. Am J Obstet Gynecol. 2003;188(6):1383-92.

ACOG Committee on Practice Bulletins – Gyceology. ACOG Practice Bulletin No.109. Cervical Cytology screening. Obstet Gynecol. 2009.

American College of Obstetricians and Gynecologists. ACOG Committee Opinion No.463: Cervical cancer in adolescents: screening, evaluation and management. Obstet Gynecol. 2010.

Seethalakshmi GV. A comparative study of PAP smear findings among the HIV positive and negative women at Government Hospital of Thoracic Medicine (GHTM), Tambaram. BMC Infectious Diseases. 2012;12(1):P35.

BM Jha, Patel M. A study on cervical PAP smear examination in patients living with HIV. National Journal of Medical Research. 2012;2(1):81-4.