title: Risk factors for abnormal anal cytology over time in HIV-infected women.
abstract: OBJECTIVE
  The objective of the study was to assess the incidence of, and risk factors for, abnormal anal cytology and anal intraepithelial neoplasia (AIN) 2-3 in human immunodeficiency virus (HIV)-infected women.
  
  
  METHODS
  This prospective study assessed 100 HIV-infected women with anal and cervical specimens for cytology and high-risk human papillomavirus (HPV) testing over 3 semiannual visits.
  
  
  RESULTS
  Thirty-three women were diagnosed with an anal cytologic abnormality at least once. Anal cytology abnormality was associated with current CD4 count less than 200 cells/mm(3), anal HPV infection, and a history of other sexually transmitted infections (STIs). Twelve subjects were diagnosed with AIN2-3: 4 after AIN1 diagnosis and 4 after 1 or more negative anal cytology. AIN2-3 trended toward an association with history of cervical cytologic abnormality and history of STI.
  
  
  CONCLUSIONS
  Repeated annual anal cytology screening for HIV-infected women, particularly for those with increased immunosuppression, anal and/or cervical HPV, a history of other STIs, or abnormal cervical cytology, will increase the likelihood of detecting AIN2-3.
authors.affiliation: Section of Infectious Diseases, Department of Medicine, Boston Medical Center, Boston University School of Medicine, MA, USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Baranoski
authors.forename: Richa
authors.initials: R
authors.lastname: Tandon
authors.forename: Janice
authors.initials: J
authors.lastname: Weinberg
authors.forename: Faye F
authors.initials: FF
authors.lastname: Huang
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stier
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000473:pathology* / Q000821:virology; D001005:Anus Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D018791:CD4 Lymphocyte Count; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D002584:Cervix Uteri / Q000821:virology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D030361:Papillomavirus Infections / Q000453:epidemiology; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology