Cervical Epithelial Abnormalities and Associated Factors among HIV-Infected Women in Lagos, Nigeria: A Cytology-Based Study

Abstract

<b><i>Introduction:</i></b> As it may not be feasible to provide cervical cancer screening services to all HIV-infected women in most resource-limited settings, there is a need to identify those who are most at risk. We determined the prevalence, patterns, and associated factors of cervical cytological abnormalities among HIV-infected women in Lagos, Nigeria. <b><i>Methods:</i></b> This descriptive cross-sectional study was conducted among HIV-infected women at the adult HIV treatment and colposcopy clinics of a university teaching hospital in Lagos, Nigeria, between October 2018 and December 2019. A cervical sample was collected from each woman to detect cervical cytological abnormalities. <b><i>Results:</i></b> Of the 593 enrolled women, cervical cytological abnormalities were present in 40 (6.7%). Most (37.5%) of the women with cytological abnormalities had atypical squamous cells of undetermined significance. Age at coitarche (<20 vs. ≥20 years: adjusted odds ratio, 2.42; 95% confidence interval, 1.21–4.83, <i>p</i> = 0.01) was the only factor that was independently associated with cervical epithelial abnormalities. <b><i>Conclusion:</i></b> The prevalence of cervical cytological abnormalities in our study is lower than most previous reports in Africa. Sexual debut at an early age was significantly associated with cytological abnormalities. It is necessary to confirm the findings of this study through a well-designed and adequately powered longitudinal study.

Human papillomavirus serotypes and determinants among women with invasive cervical cancer in Katsina state, Northwest-Nigeria: a multicentre study

“…Table 5 summarizes the histologically confirmed tumour type among the women. Of the 66 women, squamous cell carcinoma (SCC) was the most commonly diagnosed seen among 77.3% (51). The keratinizing form was the most common and accounted for 78.4% of the SCC type and 60.6% of whole histological types.…”

“…HIV infection is strongly associated with HPV infection. Several studies have shown that higher prevalence and persistence of HPV are all more frequent in HIV positive women [ 21 , 46 , 51 ]. In this study, only 5 (7.5) were HIV-Positive.…”

Prevalence and Associated Factors of High-Risk Human Papillomavirus Infections among Human Immunodeficiency Virus-Infected Women in Lagos, Nigeria

“…Each month, the LUTH HIV treatment clinic delivers comprehensive care to approximately 9,000 individuals living with HIV in Lagos and the surrounding states of Southwest Nigeria. The clinic also offers integrated reproductive health care to sexually active women with HIV infection such as routine cervical cancer screening with either a Pap smear, HPV DNA testing or visual inspection with acetic acid (VIA) [10].…”

“…Therefore, due to impaired immune function, there is an increased susceptibility to persistent HR-HPV infection due to ineffective viral clearance in HIV-infected individuals [5][6][7][8] that leads to the development of cervical intraepithelial neoplasia which can progress to invasive cervical cancer, if left untreated [4,9,10].…”

“…Nigeria, the most populous country in Africa, faces signi cant public health challenges related to both HIV and cervical cancer [6,11]. Lagos, the most populous state and commercial capital of Nigeria presents a microcosm of these challenges, with a high burden of HIV infection and limited resources for comprehensive cervical cancer screening and prevention [10,12]. Despite the signi cant risk of HR-HPV infection, data on its prevalence among women living with HIV (WLHIV) in Lagos is sparse [12,13], thus limiting the ability to effectively design interventions to address this dual burden risk factor of cervical cancer.…”