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CERVICAL CYTOLOGY PATTERN AMONG HUMAN IMMUNODEFICIENCY VIRUS SERO-POSITIVE WOMEN AT THE FEDERAL TEACHING HOSPITAL ABAKALIKI NIGERIA
Abstract
BACKGROUND Carcinoma of the cervix is a global public health problem responsible for an estimated 300,000 deaths annually. It is the commonest female genital tract malignancy in Nigeria. Cervical cancer can be prevented by routine screening aimed at detecting premalignant and early invasive lesions. The Papanicolaou smear introduced in 1943 for the detection of precancerous and cancerous changes in the cervix is widely recognized as an effective screening test and serves as a model for screening for other malignancies. Its use has reduced mortality from cancer of the cervix by 60 – 70% in countries with well organized screening programs. Unfortunately, such programs are not very effective in Nigeria.This has made cancer of the cervix to be the commonest cause of mortality from female genital tract malignancy in Nigeria. Several studies have demonstrated a higher prevalence of abnormal cervical cytology in HIV positive than HIV negative women. Since cervical cancer may have a more fulminant course in HIV infected women and has become an AIDS defining illness, the surveillance and treatment of cervical dysplasia may need to be more aggressive in these patients.
OBJECTIVES
The objective of this study is to determine the prevalence,types and degree of abnormal cervical cytology in HIV positive and HIV negative women as well as to determine if there is any relationship between the CD4 cell count and the abnormal cervical smear.
METHODOLOGY
The study was a prospective cross sectional study of 206 HIV positive and 208 HIV negative women attending the HIV clinic and the general outpatients clinic at the Federal teaching Hospital Abakaliki..Papanicolaou smear was collected from both HIV positive and HIV negative women who gave consent to participate in the study and the
results analysed.Statistical analysis of results was carried out using the SPSS version 16 software package.
RESULTS
The prevalence of squamous intraepithelial lesion(SIL) was 6.3% in HIV Positve patients and 1% in HIV negative patients . X2 =11.550,P-Value-0.013. Low CD+4 Count was associated with increased risk for for SIL X2=52.660,P-Value=0.001.Poor educational level and low CD+count were found to have increased risk factor for SIL.
