Screening HIV-infected women for cervical cancer in Thailand: findings from a demonstration project.
OBJECTIVE
Although cervical cancer is an AIDS-defining illness, few HIV-infected women are routinely screened for cervical cancer in Thailand. We screened HIV-infected women for cervical cancer as a component of HIV care and assessed high-risk human papillomavirus (HPV) and cervical cancer prevalence.


METHODS
From July 2003 through February 2004, HIV-infected women attending either an infectious disease clinic or a sexually transmitted infection (STI) clinic in Bangkok were tested for high-risk HPV types by Hybrid Capture 2 and screened for cervical cancer by Pap test; those with abnormal cervical cytology were referred for diagnosis and treatment.


RESULTS
Two hundred ten HIV-infected women at an infectious disease clinic (n = 150) and an STI clinic (n = 60) received cervical cancer screening. The high-risk HPV prevalence was 38.6% and the prevalence of abnormal cervical cytology was 20.4%. Abnormal cervical cytology and high-risk HPV detection were associated (P < 0.001). We received pathology reports for 23 (53.5%) of 43 women, including all those with a Pap test showing high-grade squamous intraepithelial lesions; the cervical cancer prevalence was 1.9% (4 of 210; 95% confidence interval, 0.5-4.8%).


CONCLUSIONS
The estimated prevalence of high-risk HPV and cervical cancer among HIV-infected women in Thailand was high. This emphasizes the need to integrate cervical cancer screening into HIV care.
Sirivongrangson
Pachara
P
STI Division, Bureau of AIDS, TB and STIs, Thai Ministry of Public Health (MOPH), Bangkok, Thailand.
Bollen
Liesbeth J M
LJ
Chaovavanich
Achara
A
Suksripanich
Orapin
O
Virapat
Pongsri
P
Tunthanathip
Preecha
P
Ausavapipit
Jarurnsook
J
Lokpichat
Somchai
S
Siangphoe
Umaporn
U
Jirarojwat
Naiyana
N
Pobkeeree
Vallerut
V
Supawitkul
Somsak
S
Tappero
Jordan W
JW
Levine
William C
WC
D000328:Adult; D052685:Alphapapillomavirus / Q000254:growth & development*; D005260:Female; D006678:HIV / Q000254:growth & development*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D013785:Thailand / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology*