Cervical cytological screening in HIV-infected women in Dublin--a six-year review.
A retrospective study of the results of cervical cytological screening of HIV-infected women attending an inner city ambulatory HIV clinic over a 6-year period between 1987 and 1992 was carried out. During this time a total of 165 HIV-infected women attended for management of their HIV disease. The results of cervical cytological specimens (smears) were available in 136 (82.4%) women. The risk categories for HIV infection of these 136 women were intravenous drug use 110 (80.9%), heterosexual sex 24 (17.6%) and undetermined 2 (1.5%). Eighty-five (62.5%) of the 136 women were classified CDC group 2, 30 (22%) CDC group 3, and 21 (15.5%) CDC group 4 at the time of initial cytological screening. Forty-one (30.1%) women had mild dysplasia/CIN 1, 21 (15.4%) had moderate dysplasia/CIN 2 and 17 (12.5%) had severe dysplasia/CIN 3. The overall prevalence of dysplasia/CIN was 58.1%. Twenty-seven (34.2%) of the women with dysplasia/CIN had cytological evidence of human papillomavirus infection. No association between the clinical stage of HIV disease and the presence or degree of dysplasia/CIN was demonstrated. Women with cytological evidence of CIN were significantly more likely to have had genital warts than those with no evidence of CIN (OR 3.1, CI 1.1-10). In those women with cervical dysplasia who underwent colposcopic examination, CIN was confirmed in a high proportion of cases. The default rate from colposcopy, however, was high (35.4%).
Murphy
M
M
Department of Genitourinary Medicine, St James's Hospital, Dublin, Ireland.
Pomeroy
L
L
Tynan
M
M
Murphy
J F
JF
Mulcahy
F M
FM
D000328:Adult; D003127:Colposcopy; D005260:Female; D015658:HIV Infections / Q000145:classification / Q000150:complications*; D006801:Humans; D007494:Ireland; D008403:Mass Screening / Q000379:methods*; D009367:Neoplasm Staging; D015995:Prevalence; D012189:Retrospective Studies; D014504:Urban Health; D002583:Uterine Cervical Neoplasms / Q000209:etiology / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000209:etiology / Q000473:pathology*