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J Acquir Immune Defic Syndr. 1999 May 1;21(1):33-41.

Prevalence and predictors of squamous cell abnormalities in Papanicolaou smears from women infected with HIV-1. Women's Interagency HIV Study Group.

Author information

  • 1Department of Obstetrics and Gynecology, Cook County Hospital and Rush Medical College, Chicago, Illinois, USA. lsmassad@ameritech.net

Abstract

BACKGROUND:

Cervical neoplasia occurs with increased frequency among women infected with HIV-1.

OBJECTIVE:

To characterize prevalence of and risk factors for abnormal cervical cytology among women with HIV and to compare them to uninfected women.

METHODS:

Baseline cervical cytology was obtained from 1713 women seropositive for HIV and 482 at-risk control women who were enrolled in the Women's Interagency HIV Study, a multicenter prospective cohort study conducted in six U.S. cities. Associations with sociodemographic, medical, and sexual variables were assessed by Fisher's exact test, Mantel extension test, and logistic regression analysis.

RESULTS:

Cervical cytology was abnormal in 38.3% of HIV-infected women (atypical squamous cells of uncertain significance [ASCUS] 20.9%, low-grade squamous cells of uncertain significance [LSIL] 14.9%, high-grade squamous cells of uncertain significance [HSIL] 2.3%, cancer 0.2%) and 16.2% of HIV-uninfected women (ASCUS 12.7%, LSIL 2.3%, HSIL 1.2%, cancer 0.0%). Risk factors for any abnormal cytology in multivariate analysis included HIV infection, CD4 cell count, HIV RNA level, detection of human papillomavirus (HPV), a prior history of abnormal cytology, employment, and number of male sex partners within 6 months of enrollment. Prior abortion was associated with a decreased risk of cytologic abnormality.

CONCLUSIONS:

Cervical cytologic abnormalities were frequent among women infected with HIV, although high-grade changes were found in only 2.5%. Factors linked to sexual and reproductive history, HPV infection, and HIV disease all influenced risk.

PMID:
10235512
[PubMed - indexed for MEDLINE]
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