Squamous cervical lesions in women with human immunodeficiency virus: long-term follow-up.
OBJECTIVE
To estimate the frequency of and trends in abnormal Pap test results in women with human immunodeficiency virus (HIV) and HIV-uninfected women.


METHODS
In a cohort study of HIV-infected and uninfected women, Pap tests were obtained every 6 months. Results of atypical squamous cells of undetermined significance (ASC-US) or worse were considered abnormal.


RESULTS
Over a median of 8.4 years, 23,843 Pap tests were obtained from 1,931 HIV-positive women with 6,828 Pap tests from 533 HIV-negative women (13 women seroconverted during the study). Among women with HIV, Pap test results were ASC-US in 4,462 (19%), low-grade squamous intraepithelial lesion (LSIL) in 3,199 (13%), high-grade squamous intraepithelial lesion (HSIL) in 267 (1%), and cancer in 11 (0.05%). The incidence of abnormal Pap test results was 179 in 1,000 person-years for HIV-positive and 75 in 1,000 person-years for HIV-negative women (incidence rate ratio 2.4, 95% confidence interval 2.0-2.8). The incidence of HSIL or cancer was 4.4 in 1,000 person-years for HIV-positive and 1.3 in 1,000 person-years for HIV-negative women (incidence rate ratio 3.4, 95% confidence interval 1.2-9.5).


CONCLUSIONS
Among women with HIV in a cervical cancer prevention program, Pap test abnormalities are common, but high-grade abnormalities are infrequent.


METHODS
II.
Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, Missouri 63110, USA. massadl@wudosis.wustl.edu
L Stewart
LS
Massad
Eric C
EC
Seaberg
Rodney L
RL
Wright
Teresa
T
Darragh
Yi-Chun
YC
Lee
Christine
C
Colie
Robert
R
Burk
Howard D
HD
Strickler
D Heather
DH
Watts
D000328:Adult; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000473:pathology*; D006679:HIV Seropositivity / Q000473:pathology; D006801:Humans; D002583:Uterine Cervical Neoplasms / Q000473:pathology; D014626:Vaginal Smears