Cervical cytological abnormalities and human papilloma virus infection in women infected with HIV in Southern India

Thunga, Suchitra; Andrews, Anusmitha; Ramapuram, John T; Satyamoorthy, Kapaettu; Kini, Hema; Unnikrishnan, Bhaskaran; Adhikari, Prabha; Singh, Pratibha; Kabekkodu, Shama Prasada; Bhat, Sevitha; Kadam, Anagha; Shetty, Avinash K.

doi:10.1111/jog.13111

Cited by 9 publications

(10 citation statements)

References 34 publications

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“…In the present study, a significant number of HIV-positive females ( n = 18, 12%) had epithelial cell abnormalities as compared to the HIV-negative control group, which was similar to other studies carried out on HIV-positive women [13, 14]. Pap smear abnormalities were twice as high in HIV-infected women (12%) as compared to HIV-negative women (6%).…”

Section: Discussionsupporting

confidence: 77%

A Study of Pap Smears in HIV-Positive and HIV-Negative Women from a Tertiary Care Center in South India

et al. 2019

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Objectives: The aim of this work was to study the spectrum of epithelial abnormalities on Pap smears of HIV-positive women categorized as per the Bethesda System of Reporting Cervical Cytology, to correlate them with CD4 lymphocyte counts, and to compare them with the spectrum of abnormalities seen in a HIV-negative control group. Study Design and Methodology: The present study was a 6-year retrospective study conducted in the Department of Pathology at Kasturba Medical College, Mangalore, which included 150 Pap smears from HIV-positive and HIV-negative women, respectively. The Pap-stained slides of the cases were retrieved and studied. The data collected were tabulated and analyzed. A statistical study was performed using SPSS software. The χ² test was used to analyze the data and a p value < 0.05 was considered to be significant. Results: Pap smear abnormalities were twice as high in HIV-infected women (12%) as compared with HIV-negative women (6%; p = 0.006, RR = 2). Negative for intraepithelial lesion/malignancy was the most common finding (88%), which was further subdivided into inflammatory, atrophic smear, non-specific, candidiasis, and bacterial vaginitis groups. The percentage of epithelial abnormalities was 12%, including: atypical squamous cells of undetermined significance, 5.55%; atypical squamous cells, cannot exclude HSIL, 16.66%; low-grade squamous intraepithelial lesion, 5.55%; high-grade squamous intraepithelial lesion (HSIL), 61.11%, and squamous cell carcinoma, 11.11%. The highest incidence of intraepithelial lesions in HIV-positive females was in the age group of 34–49 years. CD4 cell counts fell in the range of 200–500 cells/mm³ in most of the HIV-positive patients (68.75%), but was not found to be statistically significant. Conclusion: Routine Pap smear examination is advocated in women with HIV as the prevalence of epithelial cell abnormalities was found to be 12%, which was twice as high as compared to the HIV-negative control group. Although there was no correlation of epithelial cell abnormalities with CD4 counts, a higher rate of the cases with epithelial abnormalities were observed to have CD4 cell counts of 200–500 cells/mm³.

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Section: Discussionsupporting

confidence: 77%

A Study of Pap Smears in HIV-Positive and HIV-Negative Women from a Tertiary Care Center in South India

et al. 2019

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“…This data corroborate previous reports [46,47]. However, this rate is much lower than the rates reported in sub-Saharan Africa, which ranged from 49.8% to 73% [48] and India (27.5%) [15].…”

Section: Discussionsupporting

confidence: 65%

“…HPV prevalence and genotype distribution varied in a different geographic area (15)(16)(17)(18)(19)(20)(21). Two prophylactic HPV vaccines, Gardasil (Merck & Co, White House Station, NJ) and Cervarix (GlaxoSmithKline Biologicals, Rixensart, Belgium) were licensed in Morocco since 2008.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the number of deaths was estimated to 1,200 (< 1,000 -1,800) [13]. Previous studies suggested that women infected with HIV have a higher prevalence of HPV infection [14,15]. In fact, the HIV/acquired immunodeficiency syndrome (AIDS)-478 related immunosuppression increases the risk of persistent HPV infection resulting in higher incidence and prevalence of cervical intraepithelial neoplasia (CIN) lesions and a more prone to progress to cancerous lesions of the cervix and seems to occur at a younger age [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies suggested that women infected with HIV have a higher prevalence of HPV infection [14,15]. In fact, the HIV/acquired immunodeficiency syndrome (AIDS)-478 related immunosuppression increases the risk of persistent HPV infection resulting in higher incidence and prevalence of cervical intraepithelial neoplasia (CIN) lesions and a more prone to progress to cancerous lesions of the cervix and seems to occur at a younger age [15][16][17]. Moreover, highly active antiretroviral therapy (HAART) has increased the life-spans of HIVinfected women, thus has increased their risk for a prolonged period of persistence of HPV infection [18].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study

Ouladlahsen¹,

Fayssel

Bensghir³

et al. 2018

J Infect Dev Ctries

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Introduction: Women infected with human immunodeficiency virus (HIV) have a higher risk of contracting human papillomavirus (HPV) infections and are more prone to develop cervical cancer. The objective of this study was to determine the prevalence of HPV and its association with risk factors among Moroccan women living with HIV/AIDS. Methodology: We enrolled 251 HIV-infected non-pregnant women in Morocco from February 2013 to September 2016. Sociodemographic, lifestyles, behavioral and clinical data were collected. Polymerase chain reaction followed by sequencing were performed for molecular detection and HPV genotyping in cervical samples, respectively. Results: Abnormal cervical smears were found in 34/246 patients (13.82%). The overall prevalence of HPV was 74.50%. HPV 58 was the most prevalent (39.29%) followed by HPV 18 (10.71%), HPV 70 (8.93%), HPV 33 (7.14%), HPV 6 (6.25%) and other genotypes (< 3%). Overall, high-risk HPV (HR-HPV) types were present in 75% (84/112) of patients and the prevalence of HR-HPV types in samples with abnormal Pap was higher than in normal Pap (55/83, 66.27% vs. 28/83,33.33%, p < 0.0001). Univariate analyses showed that none of the socio-demographic and behaviors factors was associated with HPV infection. Moreover, Pap results were not affected by HPV status (p = 0.532). Whereas, CD4 T-cell counts above 200/mm 3 at enrolment were apparently not protective to HPV infection. We found a high prevalence of HPV infection and HR-HPV types among HIV-positive women that significantly associated with abnormal Pap. Conclusion: Our findings suggest a high prevalence of HPV infection with high-risk types was observed among HIV-positive women warrant to implement a regular screening by Pap smear.

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Strategies and implementation outcomes of HPV-based cervical screening studies to prevent cervical cancer in India: A systematic review

Oommen,

Ashfaq,

Cherian

et al. 2024

Journal of Cancer Policy

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Cervical cytological abnormalities and human papilloma virus infection in women infected with HIV in Southern India

Abstract: The high prevalence of HPV infection and cervical intraepithelial neoplasia in HIV-infected women warrants the need for regular Pap smear screening in these women and routine HPV vaccination for adolescents to reduce the burden of cervical cancer in India.

Cited by 9 publications

References 34 publications

A Study of Pap Smears in HIV-Positive and HIV-Negative Women from a Tertiary Care Center in South India

A Study of Pap Smears in HIV-Positive and HIV-Negative Women from a Tertiary Care Center in South India

The Human papillomavirus among women living with Human Immunodeficiency Virus in Morocco A prospective cross-sectional study

Strategies and implementation outcomes of HPV-based cervical screening studies to prevent cervical cancer in India: A systematic review

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