Abnormal Vaginal Cytology in HIV-Infected and At-Risk Women after Hysterectomy

Pangaja Paramsothy, Ann Duerr, Charles M. Heilig, Susan Cu-Uvin, Jean Anderson, Paula Schuman, Robert S. Klein

Research output: Contribution to journalArticle

Abstract

Objective: To determine the frequency of and risk factors for abnormal vaginal Papanicolaou smears in HIV-infected women after hysterectomy. Methods: Data were from the HIV Epidemiology Research (HER) study, a prospective multisite study of HIV-infected and uninfected women. Semiannual vaginal Papanicolaou smears and colposcopy data were obtained from 102 HIV-infected and 46 at-risk women who had hysterectomy either before or during the study. Analytic models used include Cox proportional hazards (women with hysterectomy during the study) and multiple logistic regressions, which corrected for repeated measures (all women). Results: Among the HIV-infected women, evidence of cervical intraepithelial neoplasia before or at hysterectomy was associated with abnormal cytology during follow-up; 63% had squamous intraepithelial lesions (SIL) on vaginal Papanicolaou smears following hysterectomy. CD4 counts of 10,000 copies/mL at hysterectomy were predictive of SIL vaginal cytology. Prevalent SIL vaginal cytology was associated with low CD4 count and human papillomavirus risk type. Of the 102 HIV-infected women, 16 (16%) had vaginal intraepithelial neoplasia on biopsy. Conclusions: The high rate of SIL on vaginal Papanicolaou smears and the presence of high-grade vaginal intraepithelial neoplasia among HIV-infected women after hysterectomy demonstrate the need for continued follow-up for lower genital tract lesions.

Original languageEnglish (US)
Pages (from-to)484-491
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume35
Issue number5
DOIs
StatePublished - Apr 15 2004

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Hysterectomy
Cell Biology
HIV
Papanicolaou Test
Vaginal Smears
CD4 Lymphocyte Count
Colposcopy
Cervical Intraepithelial Neoplasia
Neoplasms
Epidemiology
Logistic Models
Prospective Studies
Biopsy
Squamous Intraepithelial Lesions of the Cervix
Research

Keywords

  • HIV
  • Human papillomavirus
  • Hysterectomy
  • Squamous intraepithelial lesion
  • Vaginal intraepithelial neoplasia
  • Vaginal smears
  • Women

ASJC Scopus subject areas

  • Virology
  • Immunology

Cite this

Abnormal Vaginal Cytology in HIV-Infected and At-Risk Women after Hysterectomy. / Paramsothy, Pangaja; Duerr, Ann; Heilig, Charles M.; Cu-Uvin, Susan; Anderson, Jean; Schuman, Paula; Klein, Robert S.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 35, No. 5, 15.04.2004, p. 484-491.

Research output: Contribution to journalArticle

Paramsothy, Pangaja ; Duerr, Ann ; Heilig, Charles M. ; Cu-Uvin, Susan ; Anderson, Jean ; Schuman, Paula ; Klein, Robert S. / Abnormal Vaginal Cytology in HIV-Infected and At-Risk Women after Hysterectomy. In: Journal of Acquired Immune Deficiency Syndromes. 2004 ; Vol. 35, No. 5. pp. 484-491.
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