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Low‐grade squamous intraepithelial lesions among women with HIV
Author(s) -
Manamela Portia K.,
Kgomo Koena A.,
Gelderen Cyril J.,
Lekha Anushka R.,
Michelow Pamela,
Berg Eunice J.,
Adam Yasmin
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12505
Subject(s) - medicine , colposcopy , interquartile range , odds ratio , cervical intraepithelial neoplasia , histology , squamous intraepithelial lesion , gynecology , obstetrics , retrospective cohort study , cytology , cross sectional study , cervical cancer , pathology , cancer
Objectives To assess whether women with HIV who had low‐grade squamous intraepithelial lesions (LSIL) on cytology had cervical disease. Methods The present retrospective cross‐sectional study included data from women with LSIL who attended a tertiary hospital in South Africa between April 1, 2003, and December 31, 2013. Patient information was extracted from a colposcopy database. Results The study included 652 patients. The median age was 36 years (interquartile range [IQR] 31–42 years; range 18–66 years) and the median parity was three (IQR 2–5; range 0–10). In all, 266 (40.8%) women had a histology result of HPV or cervical intraepithelial neoplasia 1 (CIN1); 386 (59.2%) had a histology result of CIN2 or higher. The median cluster of differentiation 4 (CD4) count was 275.00 cells/mm 3 (IQR 173.50–434.00 cells/mm 3 ; range 2–1211 cells/mm 3 ). A total of 312 (47.9%) women were using antiretroviral therapy. Use of antiretroviral therapy (unadjusted odds ratio 0.57; P =0.001) and a CD4 count of at least 200 cells/mm 3 (unadjusted odds ratio 0.81; P =0.002) were associated with a histology result of HPV or CIN1. Conclusion Most of the women with a cytology report of LSIL had CIN2 or higher, suggesting that the practice of referral for colposcopy should continue.