Cervical intraepithelial neoplasia (CIN) in HIV-infected women: prevalence, Pap smear validity, and the role of immunosuppression (Meeting abstract).

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Cervical intraepithelial neoplasia (CIN) in HIV-infected women: prevalence, Pap smear validity, and the role of immunosuppression (Meeting abstract).

24th Annual Meeting of the Society of Gynecologic Oncologists. February 7-10, 1993, Palm Desert, CA, A32 1993. Unique Identifier : AIDSLINE ICDB/94698473
Wright T; Chiasson M; Ellerbrock T; Cervical Disease Study Group, Columbia Presbyterian Hosp., New; York, NY

Abstract: Objectives and design: Recent reports have suggested that in HIV-infected women the risk of cervical cancer and its precursors is increased and Pap smear screening may not be valid. We have performed a cross-sectional study of 303 HIV-infected women to better determine the prevalence of CIN, the association between CIN and CD4+ count, and the sensitivity and specificity of Pap smears in HIV-infected women. All 303 women were evaluated with simultaneous Pap smears and colposcopy with cervical biopsies, when indicated. Results: Of the 303 women, 64 (21%) had CIN that was confirmed by colposcopy and/or biopsy. Twenty-one (33%) of the 64 cervical lesions were high-grade CIN, but no invasive cancers were found. The prevalence of CIN was 29% in 79 women with CD4+ less than 200 cell/mm3, and 17% in 80 women with CD4+ greater than 500 cells/mm3 (p less than 0.05). The sensitivity and specificity of Pap smears for detecting CIN in HIV-infected women were 0.76 and 0.96, respectively. Conclusion: This study confirms the high prevalence of CIN in HIV-infected women, but found Pap smear screening as effective in HIV-infected women as in previous studies of uninfected women. However, since HIV-infected women have a high prevalence of CIN, the findings of this study and our understanding of CIN in uninfected women suggest that HIV-infected women initially have two Pap smears within a 6-month period to reduce the risk of missing significant cervical disease because of a false negative Pap smear.

Keywords: Cervix Neoplasms/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY CD4-Positive T-Lymphocytes Female Human HIV Infections/*COMPLICATIONS/IMMUNOLOGY/PATHOLOGY Leukocyte Count Vaginal Smears ABSTRACT
940830
M9480803

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