Underlying Histopathology of HIV-infected Women with Squamous Cell Abnormalities on Cervical Cytology

This study was undertaken to evaluate the underlying histopathology of HIV-infected women who hadabnormal cervical cytology. HIV-infected women with abnormal cervical cytology undergoing colposcopy atChiang Mai University Hospital between January 2001 and February 2008 were reviewed. The cohorts werematched and compared with an HIV-negative group. During the study period, 65 HIV-infected women withabnormal cervical cytology were available for review. The abnormal cervical smears were atypical squamouscell (9), low-grade squamous intraepithelial lesion (22), high-grade squamous intraepithelial lesion (27), andsquamous cell carcinoma (7). When stratified by severity of abnormal cytology, HIV-infected women had ahigher risk of having cervical intraepithelial neoplasia II or higher, whether the cervical smear showed lowgrade(P=0.01) or high-grade abnormality (P=0.04) compared with the HIV negative group. After adjustmentby age, parity, and menopausal status, HIV-infected women had 2.56 times the risk of having CIN II or higher(69.2% of HIV-infected women compared with 47.7% of HIV negative women; 95% CI=1.21-5.40, P=0.01). Inconclusion, HIV-infected women with abnormal Pap smears are a population subset with higher risk of significantcervical lesions, irrespective of severity of abnormal cervical smears.