Document Type : Research Articles
Department of Medical Laboratory Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria Nsukka, Nigeria.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria Nsukka, Nigeria.
Objective: Evaluation of prevalence and risk factors of cervical dysplasia among Human Immunodeficiency Virus
sero-positive (HIV+ve) females on Highly Active Antiretroviral Therapy (HAART) attending HIV clinic at University of
Nigeria Teaching Hospital (UNTH) Enugu, Southeastern, Nigeria. Methods: Structured questionnaire was used to obtain
socio-demographic and risk factors data. Cervical specimens were collected from 105 HIV +ve females on HAART and
104 HIV seronegative (HIV–ve) females. Pap smears were collected using cytobrush and Ayre’s spatula in a secluded
place. Smears were made on slides and placed in 95% ethyl alcohol for conventional Pap staining and the cytobrush
washed into the preservative containers for later Immunocytochemistry staining. Blood samples were used for HIV
screening. Immunocytochemistry activity using anti-P16INK4A was carried out on the Pap smears that were positive
for cervical dysplasia. Results: Pap staining showed prevalence of cervical dysplasia among HIV+ve on HAART
19.05%, (ASCUS 14.29%, LSIL 3.81%, HSIL 0.95%) whereas HIV-ve was 6.73%, p = 0.008. Only the HSIL 0.95%
was positive for P16INK4A. Odds ratios at 95% Confident Interval of the risk factors of cervical dysplasia were thus;
HIV+ve, 3.26 (1.31-8.09), education less than secondary school 3.23 (1.25-8.37), polygamy 3.23 (1.25-8.37), smoking
1.36 (0.15-12.10), married 2.08 (0.43-2.31), grand multi gravidity 1.72 (0.72-4.11), grand multi parity 1.54 (0.66-3.61),
positive history of sexually transmitted diseases 2.49 (1.06-5.80). Uptake of cervical cancer screening was low in both
study groups, 7 (6.7%) among HIV+ve on HAART and 14 (13.5%) among HIV-ve females, P = 0.102. Conclusion:
HAART had cytoprotective effect against cervical dysplasia in HIV+ve females, by reducing progression of ASCUS to
LSIL, HSIL and cervical cancer. Progression from normal to ASCUS increased which could be due to latency or/and
prolonged persistent high risk HPV and HIV infections, of the most sexually active age group before diagnosed of HIV.