Cervical cytology and histopathologic abnormalities in women living with AIDS in São Paulo, Brazil
Pinto, V.M.; Golub, J.E.; Tancredi, M.V.; Alencar, R.S.; Miranda, A.E.
Journal of Acquired Immune Deficiency Syndromes 57(Suppl 3): S212-S216
2011
ISSN/ISBN: 1944-7884 PMID: 21857321 DOI: 10.1097/qai.0b013e31821e996eDocument Number: 250557
Women living with HIV/AIDS present with a higher prevalence of human papillomavirus (HPV) infection, higher rates of squamous intraepithelial lesions, and are more susceptible to invasive cervical carcinoma progression. We assessed the frequency of precursory cervical lesions of cancer and its risk factors for women living with HIV/AIDS. Sociodemographic, clinical, behavioral, and laboratory data were collected from medical records from 2008 to 2009 and analyzed using forward stepwise logistic regression. Medical records of 631 women were reviewed; mean age at AIDS diagnosis was 34 years old (interquartile range = 29-40 years old), 32% were <16 years old at first sexual intercourse; 61% had ≤5 sexual partners during life; 43% had been living with AIDS for ≥9 years; 47% reported previous sexually transmitted infections; 44% presented with HPV infection; and 10% presented with high squamous intraepithelial lesions. Presenting high squamous intraepithelial lesions was significantly associated with home district Human Development Index, age at AIDS diagnosis (>40 years old), time of AIDS diagnosis (>8 years), CD4 cell count <350/mm, and HPV infection. Frequent squamous intraepithelial neoplasia in these women shows the importance of gynecologic examinations in routine care and follow-up required by those who present with cervical lesions.