Sensitivity of the Papanicolaou smear in human immunodeficiency virus-infected women.
OBJECTIVE
To determine the sensitivity of the Papanicolaou smear in human immunodeficiency virus (HIV)-infected women.


METHODS
Fifty-two HIV-seropositive women underwent colposcopy and had cytologic and histologic specimens obtained. Eighty-five consecutive women seen in our colposcopy clinic who stated that they were HIV-seronegative formed the comparison group. Demographic features of the groups and cytology and histology findings were compared.


RESULTS
In HIV-infected patients, the prevalence of cervical dysplasia was 50%. An additional 15% had vulvar lesions alone. The sensitivity of cytologic smears for cervical dysplasia was 63% and specificity was 84%. These findings were not significantly different from those of a control group of women undergoing colposcopy for standard indications (P > .05). Twelve of 38 seropositive women for whom future appointments were scheduled were lost to follow-up.


CONCLUSIONS
The sensitivity of the Papanicolaou test does not appear to be diminished in HIV-seropositive women. Screening colposcopy may be justified in view of the high prevalence of cervical and vulvar dysplasia, as well as the high noncompliance rate observed in this patient population.
Korn
A P
AP
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco.
Autry
M
M
DeRemer
P A
PA
Tan
W
W
D000328:Adult; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000473:pathology*; D014626:Vaginal Smears; D014844:Vulva / Q000473:pathology