title: Cervicovaginal cytological abnormalities in patients with human immunodeficiency virus infection, in relation to disease stage, CD4 cell count and viral load.
abstract: The objective of the present study was to assess infections and cytologic abnormalities in cervicovaginal smears from 153 HIV-positive women and 169 HIV-negative followed up at the UFTM School of Medicine between May 1999 and May 2002. The medical records and cervicovaginal smears were reviewed and the HIV-positive group was classified according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups (with or without disease; with or without therapy) and compared to HIV-negative group. We conclude that the frequency of Candida sp, Trichomonas vaginalis and bacterial vaginosis in cervicovaginal smear, is not different between HIV-positive and HIV-negative women, even if the HIV-group is subdivided according to CD4 cell count, HIV viral load, antiretroviral therapy and HIV subgroups. The frequency of LSIL, in cervicovaginal smears, was greater in the HIV-group (17.6%) than in the HIV-negative (4.1%); there was no difference between the two groups according to frequency of HSIL (4.6% versus 1.8%), ASCUS/AGUS (7.8% versus 3.5%) and invasive carcinoma (1.3% versus 0.6%). The frequency of LSIL was greater in the HIV positive group with CD4 cell count < 350 cells/mm(3). The viral load, therapeutic regimen and HIV subgroups (HIV-positive without therapy, HIV-positive with therapy, AIDS by immunological criteria and AIDS by clinical criteria) have not shown relationship with LSIL frequency, until now.
authors.affiliation: Department of Special Pathology, Federal University of the Triângulo Mineiro (UFTM) School of Medicine, Uberaba-MG, Brazil. pe_fmtm@mednet.com.br
authors.forename: Adilha Misson Rua
authors.initials: AM
authors.lastname: Micheletti
authors.forename: Valéria de Freitas
authors.initials: Vde F
authors.lastname: Dutra
authors.forename: Eddie Fernando Cândido
authors.initials: EF
authors.lastname: Murta
authors.forename: Marina Carvalho
authors.initials: MC
authors.lastname: Paschoini
authors.forename: Mário Leon
authors.initials: ML
authors.lastname: Silva-Vergara
authors.forename: Gisele
authors.initials: G
authors.lastname: Barbosa e Silva
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad
mesh_terms: D000328:Adult; D000818:Animals; D018791:CD4 Lymphocyte Count; D002175:Candida / Q000302:isolation & purification; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000473:pathology*; D002689:Chlamydia / Q000302:isolation & purification; D005260:Female; D006194:Gardnerella vaginalis / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D014246:Trichomonas vaginalis / Q000302:isolation & purification; D002583:Uterine Cervical Neoplasms / Q000145:classification / Q000473:pathology*; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D019562:Viral Load