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Obstet Gynecol. 2016 Jul;128(1):52-7. doi: 10.1097/AOG.0000000000001457.

Abnormal Vaginal Pap Test Results After Hysterectomy in Human Immunodeficiency Virus-Infected Women.

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Baylor College of Medicine, the MD Anderson Cancer Center, and the Harris Health System/Baylor College of Medicine, Houston, Texas.



To evaluate the prevalence of abnormal vaginal cytology and vaginal intraepithelial neoplasia (VAIN) and vaginal cancer in human immunodeficiency virus (HIV)-infected women with no history of abnormal cytologic screening who had a hysterectomy for conditions other than cervical dysplasia and cancer and to explore the risk factors associated with VAIN and vaginal cancer.


A retrospective cohort study was performed identifying 238 women between January 2000 and January 2015 with a history of HIV, previous hysterectomy, and no previous abnormal Pap test results. Medical records from patients with both HIV and a history of hysterectomy were reviewed from Thomas Street Health Center and Northwest Community Health Center.


Among 238 women, 164 (69%) had normal Pap test results, 12 (5%) had results showing atypical cells of undermined significance and human papillomavirus-positive, 55 (23.1%) had results showing low-grade squamous intraepithelial lesion, and seven (2.9%) had results showing high-grade squamous intraepithelial lesion. No demographic risk factor was associated with abnormal Pap test results after hysterectomy. Median follow-up time for the Pap test was 16 years. Of those who underwent vaginal biopsies for abnormal Pap test results, 15 (28%) had normal results, 23 (43%) had VAIN 1, nine (16%) had VAIN 2, and seven (13%) had VAIN 3. No patients had invasive vaginal cancer.


More than 30% of HIV-infected women who had no prehysterectomy history of abnormal Pap test results had abnormal vaginal Pap test results. Among those who had vaginal biopsies, 29% had VAIN 2 or 3, suggesting that Pap testing posthysterectomy in the HIV population may be indicated.

[Indexed for MEDLINE]

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