Cervical cytology and histopathologic abnormalities in women living with AIDS in São Paulo, Brazil

J Acquir Immune Defic Syndr. 2011 Aug;57 Suppl 3(Suppl 3):S212-6. doi: 10.1097/QAI.0b013e31821e996e.

Abstract

Background: Women living with HIV/AIDS present with a higher prevalence of human papillomavirus (HPV) infection, higher rates of squamous intraepithelial lesions, and are more susceptible to invasive cervical carcinoma progression.

Objective: We assessed the frequency of precursory cervical lesions of cancer and its risk factors for women living with HIV/AIDS.

Methods: Sociodemographic, clinical, behavioral, and laboratory data were collected from medical records from 2008 to 2009 and analyzed using forward stepwise logistic regression.

Results: Medical records of 631 women were reviewed; mean age at AIDS diagnosis was 34 years old (interquartile range = 29-40 years old), 32% were <16 years old at first sexual intercourse; 61% had ≤5 sexual partners during life; 43% had been living with AIDS for ≥9 years; 47% reported previous sexually transmitted infections; 44% presented with HPV infection; and 10% presented with high squamous intraepithelial lesions. Presenting high squamous intraepithelial lesions was significantly associated with home district Human Development Index, age at AIDS diagnosis (>40 years old), time of AIDS diagnosis (>8 years), CD4 cell count <350/mm, and HPV infection.

Conclusions: Frequent squamous intraepithelial neoplasia in these women shows the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Age Distribution
  • Brazil / epidemiology
  • Cervix Uteri / cytology*
  • Female
  • HIV Infections / complications*
  • Humans
  • Middle Aged
  • Risk Factors
  • Sexual Behavior
  • Uterine Cervical Dysplasia / epidemiology*
  • Uterine Cervical Dysplasia / pathology*