Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
ASSOCIATION OF HUMAN IMMUNODEFICIENCY VIRUS AND GENITAL HUMAN PAPILLOMAVIRUS WITH PATHOLOGIC CERVICAL CYTOLOGY
Diss Abstr Int [B]; 52(1):188 1991. Unique Identifier : AIDSLINE ICDB/92677095 Vermund SH; Columbia Univ.
Abstract:
Human papillomavirus (HPV) infection is associated with cervical intraepithelial neoplasia and cancer, particularly in immunosuppressed women. The present study tests a hypothesis that coinfection with human immunodeficiency virus (HIV) and HPV increases risk for squamous intraepithelial lesions of the cervix, particularly when accompanied by signs of immunosuppression in the host. An innovative method of harvesting cervical cells for HPV testing was validated. Each of 159 women referred for colposcopic examination served as her own control for HPV assessment (Southern blot) by undergoing both a cervicovaginal lavage (CVL) and a cervical scrape/endocervical sample with a cotton swab or plastic brush to harvest cells. Sixty-one (38%) women were HPV positive using both techniques, 34 (21%) were positive with CVL alone, 1 (0.6%) was HPV positive only on scrape/swab or brush, and 63 (40%) were HPV negative using both methods (p less than 0.00001). The higher rate of HPV infection detected using the CVL could be explained by improved cell recovery and DNA yield. The relationship between HPV infection (Southern blot) of the female genital tract, systemic HIV infection (ELISA and Western blot), other sexually transmitted infections, and cervical cytology was studied in 96 women at high risk for HIV in New York City. Twenty-three of the 33 (70%) women with symptomatic HIV had HPV infection compared with 4 of 18 (22%) asymptomatic HIV seropositive and 10 of 45 (22%) HIV seronegative women (p less than 0.00001). HPV was associated with cervical cytologic abnormalities, controlled for HIV clinical status (OR [MH] = 6.4; 95% CI, 2.0-19). The rate of cervical abnormality was 52% (14 of 27) for women infected with both viruses, 18% (6 of 34) for women infected with HIV or HPV alone, and 9% (3 of 35) for uninfected women. Cervical abnormality was noted in 42% of HIV-infected women who were symptomatic, compared to 14% of women who were asymptomatic or uninfected (OR = 4.4; 95% CI, 1.6-12). Significant associations of HIV with abnormal Pap and of HPV with abnormal Pap were documented only in women with symptomatic HIV infection. HIV-induced immunosuppression may exacerbate HPV-mediated cervical cytologic abnormalities. Regular Pap smears and medical treatment are especially important for women at high risk for HIV infection. (Full text available from University Microfilms International, Ann Arbor, MI, as Order No. AAD91-18724).
Keywords: Cervix Uteri/*PATHOLOGY Female Human HIV Infections/*COMPLICATIONS Papillomavirus/*PATHOGENICITY Tumor Virus Infections/*COMPLICATIONS Vaginal Smears THESIS
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Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.
