TY - JOUR
T1 - Cervical dysplasia on cervicovaginal papanicolaou smear among HIV-1- infected pregnant and nonpregnant women
AU - Stratton, Pamela
AU - Gupta, Prabodh
AU - Riester, Katherine
AU - Fox, Harold
AU - Zorrilla, Carmen
AU - Tuomala, Ruth
AU - Eriksen, Nancy
AU - Vajaranant, Mark
AU - Minkoff, Howard
AU - Fowler, Mary Glenn
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 1999/3/1
Y1 - 1999/3/1
N2 - Objective: To assess the association of squamous intraepithelial lesions (SIL) on cervicovaginal Papanicolaou (Pap) smear among women infected with HIV-1 and their pregnancy status, and historical and clinical factors. Methods: Study enrollment Pap smears of 452 pregnant and 126 nonpregnant HIV- infected women had cytologic evaluation. The rates of SIL were compared with pregnancy status, immunosuppression, presence of sexually transmitted diseases (STDs) and demographic features. Results: Rates of low grade SIL were similar for pregnant and nonpregnant HIV-1-infected women (17% and 23.8%, respectively; p = .09). Of them, 12 women, 9 pregnant and 3 nonpregnant, had high grade SIL. None had invasive cervical cancer. Low CD4 percentage (odds ratio, [OR] = 3.8; 95% confidence interval [CI], 2.0-7.3) and inflammation (OR = 2.8; 95% CI, 1.8-4.3) were associated with SIL. An association between herpes simplex and SIL (OR = 3.3; 95% CI, 1.1-9.5) was less certain due to clinical diagnosis and low prevalence of herpes simplex (17 of 456 women). Conclusions: Pap smears for a cohort of HIV-infected pregnant and nonpregnant women revealed a high prevalence of LGSIL but a low prevalence of HGSIL and no cases of cervical cancer. Although pregnancy may not affect the rate of Pap smear abnormalities, SIL is associated with immunosuppression, cervical inflammation, and herpes simplex. Closer surveillance of HIV-1-infected women with these risk factors may be warranted.
AB - Objective: To assess the association of squamous intraepithelial lesions (SIL) on cervicovaginal Papanicolaou (Pap) smear among women infected with HIV-1 and their pregnancy status, and historical and clinical factors. Methods: Study enrollment Pap smears of 452 pregnant and 126 nonpregnant HIV- infected women had cytologic evaluation. The rates of SIL were compared with pregnancy status, immunosuppression, presence of sexually transmitted diseases (STDs) and demographic features. Results: Rates of low grade SIL were similar for pregnant and nonpregnant HIV-1-infected women (17% and 23.8%, respectively; p = .09). Of them, 12 women, 9 pregnant and 3 nonpregnant, had high grade SIL. None had invasive cervical cancer. Low CD4 percentage (odds ratio, [OR] = 3.8; 95% confidence interval [CI], 2.0-7.3) and inflammation (OR = 2.8; 95% CI, 1.8-4.3) were associated with SIL. An association between herpes simplex and SIL (OR = 3.3; 95% CI, 1.1-9.5) was less certain due to clinical diagnosis and low prevalence of herpes simplex (17 of 456 women). Conclusions: Pap smears for a cohort of HIV-infected pregnant and nonpregnant women revealed a high prevalence of LGSIL but a low prevalence of HGSIL and no cases of cervical cancer. Although pregnancy may not affect the rate of Pap smear abnormalities, SIL is associated with immunosuppression, cervical inflammation, and herpes simplex. Closer surveillance of HIV-1-infected women with these risk factors may be warranted.
KW - HIV-infected women
KW - Papanicolaou smear
KW - Pregnancy
KW - Squamous intraepithelial lesions
UR - http://www.scopus.com/inward/record.url?scp=0032948309&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032948309&partnerID=8YFLogxK
U2 - 10.1097/00042560-199903010-00014
DO - 10.1097/00042560-199903010-00014
M3 - Article
C2 - 10077181
AN - SCOPUS:0032948309
SN - 1077-9450
VL - 20
SP - 300
EP - 307
JO - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
JF - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
IS - 3
ER -