IMR Press / EJGO / Volume 21 / Issue 2 / pii/2000141

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research

Colposcopy, cytology and HPV-DNA testing in HIV-positive and HIV-negative women

Show Less
1 Institute of Gynaecology and Obstetrics, University of Padua, Italy
2 Institute of Oncology Services and Cytologic Molecular Diagnostics, University of Padua, Italy
Eur. J. Gynaecol. Oncol. 2000, 21(2), 168–172;
Published: 10 April 2000
Abstract

In this study we examined the incidence of colposcopic-colpocytologic findings and analyzed Human Papilloma Virus (HPV)­DNA testing by Polymerase Chain Reaction (PCR) in 104 Human Immunodeficiency Virus (HIV) serous positive women (Group 1) and 218 HIV-negative women (control Groups 2 and 3). The aim of the study was to evaluate the most appropriate and effica­cious diagnostic methods for screening programs for cervical cancer in HIV-positive women. For Group 1 we also considered the value of CD4+ T-lymphocytes and morphologic and molecular follow-up from 3 to 6 months. The results showed that the abnor­mal transformation zone (ANTZ) was present in 66.3% of the cases in Group I compared with 31.4% in control-Group 2 (p < 0.00 I), and with 58.93% of the cases in control-Group 3 (p = 0.257); intraepithelial squamous lesions (SIL) were found in 50% vs 5.66%(p < 0.001) and vs 56.25% of the cases (p = 0.433), respectively. In 28.85% of the HIV-positive patients the first cytological screening exam was not evaluable due to inflammation but in 56.67% of the cases colposcopy revealed ANTZ. The subsequent colpocytological checkup after therapy showed 10 cases (30%) of low risk squamous intraepithelial lesions (LSIL) and two cases (6.6%) of high risk squamous intraepithelial lesions (HSIL). HPV-DNA testing by PCR was positive in 53.8% of the cases in Group I, in 6.6% in control-Group 2 and in 42% in control-Group 3. In HIV­positive patients multiple HPV genotypes were simultaneously present in 21.43% of the cases and high risk genotypes were present in 70% of the cases of HSIL. In Group 1, 36.61 % of the cases had lesions of the lower genital tract. The value of CD4+ T-lym­pocytes was <200 cells/ml in 30% of the cases of HSIL. Our data, like those of other Authors, confirm a high incidence of HSIL, abnormal colposcopic findings, and HPV infections in HIV­positive women with respect to control-Group 2, while there was not much difference between Group 1 and control-Group 3. Such frequency again suggests that an integrated morphological diagnostic approach with colposcopy-colpocytology in the scree­ning of immunosuppressed subjects would be worthwhile.

Keywords
Human Immunodeficiency Virus (HIV)
Human Papilloma Virus (HPV)
Colposcopy
Cytology
Polymerase Chain Reaction (PCR)
Share
Back to top