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Low-grade squamous intraepithelial lesions among women with HIV.

Low-grade squamous intraepithelial lesions among women with HIV.
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Manamela PK, Kgomo KA, van Gelderen CJ, Lekha AR, Michelow P, van den Berg EJ, Adam Y,


Manamela PK, Kgomo KA, van Gelderen CJ, Lekha AR, Michelow P, van den Berg EJ, Adam Y, (click to view)

Manamela PK, Kgomo KA, van Gelderen CJ, Lekha AR, Michelow P, van den Berg EJ, Adam Y,

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International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2018 04 10() doi 10.1002/ijgo.12505

Abstract
OBJECTIVES
To assess whether women with HIV who had low-grade squamous intraepithelial lesions (LSIL) on cytology had cervical disease.

METHODS
The present retrospective cross-sectional study included data from women with LSIL who attended a tertiary hospital in South Africa between April 1, 2003, and December 31, 2013. Patient information was extracted from a colposcopy database.

RESULTS
The study included 652 patients. The median age was 36 years (interquartile range [IQR] 31-42 years; range 18-66 years) and the median parity was three (IQR 2-5; range 0-10). In all, 266 (40.8%) women had a histology result of HPV or cervical intraepithelial neoplasia 1 (CIN1); 386 (59.2%) had a histology result of CIN2 or higher. The median cluster of differentiation 4 (CD4) count was 275.00 cells/mm (IQR 173.50-434.00 cells/mm ; range 2-1211 cells/mm ). A total of 312 (47.9%) women were using antiretroviral therapy. Use of antiretroviral therapy (unadjusted odds ratio 0.57; P=0.001) and a CD4 count of at least 200 cells/mm (unadjusted odds ratio 0.81; P=0.002) were associated with a histology result of HPV or CIN1.

CONCLUSION
Most of the women with a cytology report of LSIL had CIN2 or higher, suggesting that the practice of referral for colposcopy should continue. This article is protected by copyright. All rights reserved.

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