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Obstet Gynecol. 2008 Jun;111(6):1388-93. doi: 10.1097/AOG.0b013e3181744619.

Squamous cervical lesions in women with human immunodeficiency virus: long-term follow-up.

Author information

  • 1Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. massadl@wudosis.wustl.edu

Abstract

OBJECTIVE:

To estimate the frequency of and trends in abnormal Pap test results in women with human immunodeficiency virus (HIV) and HIV-uninfected women.

METHODS:

In a cohort study of HIV-infected and uninfected women, Pap tests were obtained every 6 months. Results of atypical squamous cells of undetermined significance (ASC-US) or worse were considered abnormal.

RESULTS:

Over a median of 8.4 years, 23,843 Pap tests were obtained from 1,931 HIV-positive women with 6,828 Pap tests from 533 HIV-negative women (13 women seroconverted during the study). Among women with HIV, Pap test results were ASC-US in 4,462 (19%), low-grade squamous intraepithelial lesion (LSIL) in 3,199 (13%), high-grade squamous intraepithelial lesion (HSIL) in 267 (1%), and cancer in 11 (0.05%). The incidence of abnormal Pap test results was 179 in 1,000 person-years for HIV-positive and 75 in 1,000 person-years for HIV-negative women (incidence rate ratio 2.4, 95% confidence interval 2.0-2.8). The incidence of HSIL or cancer was 4.4 in 1,000 person-years for HIV-positive and 1.3 in 1,000 person-years for HIV-negative women (incidence rate ratio 3.4, 95% confidence interval 1.2-9.5).

CONCLUSION:

Among women with HIV in a cervical cancer prevention program, Pap test abnormalities are common, but high-grade abnormalities are infrequent.

LEVEL OF EVIDENCE:

II.

PMID:
18515523
[PubMed - indexed for MEDLINE]
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