AEGiS-15IAC: Cervical cytology in 100 HIV positive women.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Cervical cytology in 100 HIV positive women.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. A10205)

Bagga R, Wanchu A, Rajwanshi A, Prasad GR, Gopalan S
Dept. of Obstetrics & Gynaecology, PGIMER , Chandigarh, India

BACKGROUND: Dysplasias on Pap smear have been reported in 15-40% of HIV positive women. These rates are 10-11 times greater than those observed among HIV negative women. Both the Center for Disease Control & Prevention, and the Agency for Health care Policy & Research recommend that HIV -infected women have a gynaecological evaluation including a PAP smear and pelvic examination as part of their initial evaluation.

METHODS: We performed pelvic examination & obtained PAP smears in 100 HIV positive women who attended the immunodeficiency clinic of the Postgraduate Institute of Medical Education & Research, Chandigarh, India from August 2002 to December 2003. The cytology results were followed by colposcopy and / or biopsy if needed.

RESULTS: The age ranged from 21-58 years; 10 were menopausal, 2 had lactational amenorrhoea, 5 were pregnant. All were married and the majority (93) were parous. None of these women had any gynaecological symptoms. Speculum examination was clinically normal in about half the women, 21 had vaginal discharge suggestive of monilial vaginitis, 10 had vaginal discharge suggestive of a mixed infection & 16 had cervical erosion. Bimanual pelvic examination was normal in nearly all, and only two had adnexal tenderness due to PID. PAP smears were reported normal about two-third women and inflammatory in about one-fifth. Dysplasia was seen in 7 smears and invasive carcinoma in one. About 10 women underwent colposcopic examination with directed biopsies where indicated. Despite initial counseling for a need for follow-up, about one-fourth of the women did not return to collect PAP reports and among this group were four women with dysplasia.

CONCLUSION: The high incidence of dysplasia in HIV positive women supports the recommendation of regular gynaecological examination including PAP smears in all these women even if they do not have any gynaecological symptoms. However there is need to have a better follow-up so that appropriate therapeutic measures can be taken.

Keywords: AEGIS, HIV Seropositivity, Vaginal Smears, Colposcopy, Biopsy, Genital Diseases, Female, Evaluation Studies, Acquired Immunodeficiency Syndrome, Cervix Erosion, India, Humans, Female, Pregnancy

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