Cervicovaginal cytological abnormalities in patients with human immunodeficiency virus infection, in relation to disease stage, CD4 cell count and viral load

Diagn Cytopathol. 2009 Mar;37(3):164-9. doi: 10.1002/dc.20892.

Abstract

The objective of the present study was to assess infections and cytologic abnormalities in cervicovaginal smears from 153 HIV-positive women and 169 HIV-negative followed up at the UFTM School of Medicine between May 1999 and May 2002. The medical records and cervicovaginal smears were reviewed and the HIV-positive group was classified according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups (with or without disease; with or without therapy) and compared to HIV-negative group. We conclude that the frequency of Candida sp, Trichomonas vaginalis and bacterial vaginosis in cervicovaginal smear, is not different between HIV-positive and HIV-negative women, even if the HIV-group is subdivided according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups. The frequency of LSIL, in cervicovaginal smears, was greater in the HIV-group (17.6%) than in the HIV-negative (4.1%); there was no difference between the two groups according to frequency of HSIL (4.6% versus 1.8%), ASCUS/AGUS (7.8% versus 3.5%) and invasive carcinoma (1.3% versus 0.6%). The frequency of LSIL was greater in the HIV positive group with CD4 cell count < 350 cells/mm(3). The viral load, therapeutic regimen and HIV subgroups (HIV-positive without therapy, HIV-positive with therapy, AIDS by immunological criteria and AIDS by clinical criteria) have not shown relationship with LSIL frequency, until now.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • CD4 Lymphocyte Count
  • Candida / isolation & purification
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / pathology*
  • Chlamydia / isolation & purification
  • Female
  • Gardnerella vaginalis / isolation & purification
  • HIV Infections / complications
  • HIV Infections / microbiology
  • HIV Infections / pathology*
  • Humans
  • Trichomonas vaginalis / isolation & purification
  • Uterine Cervical Neoplasms / classification
  • Uterine Cervical Neoplasms / pathology*
  • Vaginal Smears
  • Vaginosis, Bacterial / complications
  • Vaginosis, Bacterial / microbiology
  • Vaginosis, Bacterial / pathology*
  • Viral Load