title: Abnormal cervical cytology among HIV-positive women in Nigeria.
abstract: OBJECTIVE
  To determine the prevalence of abnormal cervical smears and high-grade lesions among HIV-positive and HIV-negative women, and to assess the relationship between severity of disease and CD4 count.
  
  
  METHODS
  In a prospective cross-sectional comparative study, 250 HIV-positive and 250 HIV-negative women attending the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, were enrolled between January and March 2012. Cervical smear samples were collected from participants, examined, and reported via the Bethesda system. Data management and analysis was done with SPSS. Differences between the 2 study groups were determined by χ2 test and Student t test.
  
  
  RESULTS
  The prevalence of abnormal cervical smears was significantly higher among HIV-positive women (34.4%) than among HIV-negative women (20.2%) (P<0.01). The proportion of high-grade lesions was significantly higher among HIV-positive women (23.5%) than among HIV-negative women (8.2%) (P=0.025). HIV-positive women with a CD4 count below 500 cells/mm3 had significantly more abnormal cervical smears (28.3%) compared with those with a CD4 count of 500 cells/mm3 or more (6.1%) (P=0.04).
  
  
  CONCLUSIONS
  HIV-positive women were found to be at significantly greater risk of developing abnormal cervical cytology and high-grade lesions compared with HIV-negative women.
authors.affiliation: Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
authors.forename: Goddy
authors.initials: G
authors.lastname: Bassey
authors.affiliation: Department of Obstetrics and Gynecology, Niger Delta University, Wilberforce Island, Nigeria. Electronic address: dr.israel.jeremiah@gmail.com.
authors.forename: Israel
authors.initials: I
authors.lastname: Jeremiah
authors.affiliation: Department of Anatomical Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
authors.forename: John I
authors.initials: JI
authors.lastname: Ikimalo
authors.affiliation: Department of Obstetrics and Gynecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
authors.forename: Preye O
authors.initials: PO
authors.lastname: Fiebai
authors.affiliation: Department of Anatomical Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.
authors.forename: Boma P
authors.initials: BP
authors.lastname: Athanasius
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D065006:Papanicolaou Test; D011230:Precancerous Conditions / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D015995:Prevalence; D011446:Prospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*
keywords: CD4 count; Cervical cytology; HIV-positive women