Abstract
Objective: To compare the prevalence and type of human papillomavirus (HPV) infections in the genital tract of human‐immunodeficiency‐virus‐ (HIV) seropositive and ‐seronegative women matched for cytology and to examine prospectively the relationship of HPV DNA, colposcopic findings and cervical squamous intraepithelial lesions (SIL) in these matched seropositive and seronegative cohorts.Methods: A matched prospective study of HIV‐seropositive and ‐seronegative women undergoing cytologic screening, colposcopy, and testing for HPV DNA and other infections at each visit.Results: Twenty‐three HIV‐seropositive women were matched with 23 seronegative women by cervical cytology reading, lifetime number of sexual partners, age, and follow‐up length. Fourteen pairs of these women had follow‐up visits every 4 months, for 56 and 53 total visits in seropositive and seronegative women, respectively. After matching, the groups had a similar overall prevalence ofHPV DNA and ofHPV oncogenic (high risk) types at baseline. On follow up, HIV‐seropositive women were more likely than seronegative women to develop SIL (38% vs. 10%), less likely to have negative cytology (34% vs. 60%, overall P = 0.03), more visits with HPV DNA detected (68% vs. 40% P = 0.04), and more visits with multiple HPV DNA types detected (18% vs. 0%, P = 0.02). Colposcopic lesions in the seropositive women were more likely to have sharp borders or mosaicism or to be thick white (P = 0.009).Conclusions: After matching for baseline Papanicolaou smear readings, these data suggest that over time seropositive women have more visits that yield abnormal cytology, more persistent HPV DNA detection, and more colposcopic abnormalities than seronegative women. Infect. Dis. Obstet. Gynecol. 7:158–164, 1999.
Highlights
Twenty-three HIV-seropositive women were matched with 23 seronegative women by cervical cytology reading, lifetime number of sexual partners, age, and follow-up length
KEY WORDS cervical cytology; HIV seropositive; HPV DNA; colposcopy everal studies have demonstrated an increased prevalence of squamous intraepithelial lesions (SIL) in human-immunodeficiency-virus- (HIV) seropositive women. -s While the natural history of SIL in HIV-seropositive women has not been well defined, an association between increased prevalence of human papillomavirus (HPV) DNA and HIV has been found in many studies,z,4-9
HIV-seropositive and HIV-seronegative populations matched for age, number of lifetime sexual partners, and cervical cytology result
Summary
Twenty-three HIV-seropositive women were matched with 23 seronegative women by cervical cytology reading, lifetime number of sexual partners, age, and follow-up length. Fourteen pairs of these women had follow-up visits every 4 months, for 56 and 53 total visits in seropositive and seronegative women, respectively. The groups had a similar overall prevalence of HPV DNA and of HPV oncogenic (high risk) types at baseline. HIV-seropositive women were more likely than seronegative women to develop SIL (38% vs 10%), less likely to have negative cytology (34% vs 60%, overall P 0.03), more visits with HPV DNA detected (68% vs 40% P 0.04), and more visits with multiple HPV DNA types detected (18% vs 0%, P 0.02). Colposcopic lesions in the seropositive women were more likely to have sharp borders or mosaicism or to be thick white (P 0.009)
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