PREVALENCE OF CERVICAL INTRAEPITHELIAL NEOPLASIA AMONG HUMAN IMMUNODEFICIENCY VIRUS POSITIVE WOMEN

Abstract

Aim: To determine the prevalence of cervical intraepithelial neoplasia among HIV
positive women.

Method: A descriptive study of 308 consecutive HIV-positive women who were
interviewed using a structured questionnaire followed by pelvic examination, cervical
cancer screening (both VIA and Pap smear), and colposcopy and cervical biopsy for
eligible participants.

Results: The mean age of the study population was 35.4 ± 7.6 years. Almost 85%
of them had at secondary education. 107 participants were eligible for colposcopic
evaluation based on a positive cervical screening test. Colposcopy compliance rate
was 84.1%. The prevalence of biopsy-confirmed all grades of CIN was 17.3%. About
90% had CIN1 and the remaining 10% had CIN2/3.
HIV positive women with severe immunosuppression were at increased risk of CIN1
compared to HIV positive women with normal CD4+ cell count [OR 6.08 (95% CI
1.70-22.82) p <0.05]. An increased risk was also observed among HIV positive
women with CIN 2 but this was not statistically significant [OR 6.08 (95% CI 0.41
177.12) P >0.05].
There was an increased risk of CIN1 among HIV positive women on antiretroviral
therapy [OR 2.01 (95% CI 0.55-8.69) p >0.05] but this was not statistically significant.

Conclusion:
The prevalence of biopsy-confirmed cervical intraepithelial neoplasia among HIV
positive women is 17.3%. Majority of the lesions were low-grade (CIN1).
There is an increased risk of CIN1 lesion among HIV positive women with severe
degree of immunosuppression.

PREVALENCE OF CERVICAL INTRAEPITHELIAL NEOPLASIA AMONG HUMAN IMMUNODEFICIENCY VIRUS POSITIVE WOMEN