Open AccessWorld Health Organisation staging, adherence to HAART and abnormal cervical smears amongst HIV-infected women attending a government hospital in Johannesburg, South Africa
Author(s) -
Appolinaire C. Katumba,
Elizabeth Reji,
Tabither Gitau,
Cindy Firnhaber
Publication year - 2016
Publication title -
southern african journal of infectious diseases
Language(s) - English
Resource type - Journals
eISSN - 2313-1810
pISSN - 2312-0053
DOI - 10.4102/sajid.v31i4.74
Subject(s) - medicine , dysplasia , cervical cancer , human immunodeficiency virus (hiv) , obstetrics , abnormality , antiretroviral therapy , stage (stratigraphy) , viral load , gynecology , cancer , immunology , paleontology , psychiatry , biology
South Africa (SA) has more people living with Human Immunodeficiency Virus (HIV) than any other country in the world. Women infected with HIV have a higher risk of developing cervical dysplasia and cancer than women who are not infected.Objective: To ascertain the correlation between the World Health Organisation (WHO) HIV staging and adherence to highly active antiretroviral therapy (HAART) with abnormal Pap smear results of HIV-infected women attending a government hospital in Johannesburg, SA.Methods: A cross-sectional descriptive study was performed by reviewing Pap smears of 390 HIV-positive women. Adherence was measured by the patient’s report and viral load. Data was collected through the use of self-administered questionnaires.Results: The prevalence of abnormal Pap smears was 57% and low grade squamous intraepithelial lesions (LGSIL) were the most common abnormality seen (142/390, 36%). WHO stage 3 participants were three times more likely to have abnormal Pap smears than those with WHO stage 1 (OR 3.3, 95% CI 1.23-9.04, p = 0.018). Abnormal Pap smears were seen more frequently in participants with a CD4 cell count ≤ 350 cells/μl compared to participants with CD4 cell count ≥ 500 cells/μl (p = 0.001, 95% CI 0.09-0.37). Participants who did not use HAART had more abnormal results compared to those who used HAART (p 0.028, 95% CI 0.28-0.93). Self-reported adherence to HAART did not show any association with abnormal Pap smears.Conclusion: Increased immune-suppression measured by WHO staging or CD4 count increases the risk of cervical cancer precursors. The high risk group in this study was found to be participants with CD4 350 cells/μl.