Histology/cytology discrepancies in HIV-infected obstetric patients with normal pap smears

Gynecologic Oncology
W R RobinsonM S Perrin

Abstract

To estimate the frequency of cervical cytologic/histologic discrepancies in a group of obstetric patients diagnosed as HIV infected by routine prenatal screening. Also, to determine if serum CD4 levels or sexually transmitted diseases (STDs) are associated with the occurrence of preinvasive cervical disease in these women. Thirty-two women who presented for routine prenatal care to Medical Center of Louisiana were diagnosed as HIV infected by ELISA and Western blot testing and had normal Pap smears. These patients then agreed to undergo the following: colposcopy with directed biopsies; chlamydia, gonorrhea, and syphilis screening; and serum CD4 level. No patients had AIDS-defining diagnoses other than CD4 < 200/mm3. Ten of 32 (31%) had cervical intraepithelial neoplasia (CIN) despite normal cytology. Six of 32 (19%) had STDs. One of 10 in the group with CIN had a STD. The mean CD4 level in those patients with CIN was 249/mm2 (range 1-524) vs 501/mm2 (range 210-979) in those without CIN. (P = 0.0118) Newly diagnosed HIV-infected pregnant women without clinical evidence of AIDS are noted to have CIN at a rate similar to nonpregnant HIV-infected women. The Pap smear appears to have a significant false-negative rate in this group. ...Continue Reading

References

Sep 1, 1990·Gynecologic Oncology·M MaimanJ Boyce
Aug 1, 1993·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R A ClarkC Pindaro

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Citations

Apr 4, 2001·Cytopathology : Official Journal of the British Society for Clinical Cytology·M BrancaK Syrjänen
Mar 5, 2002·AIDS Patient Care and STDs·William R Robinson, Dudley Freeman
Jun 18, 1998·Primary Care·B S Apgar, L B Zoschnick
Oct 3, 2015·AIDS Patient Care and STDs·W R Robinson

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