Analysis of Cytology and Histopathology Results in an Immunocompromised Population [13E

Abstract

INTRODUCTION: HIV and Renal Transplant patients are in general at higher risk for cervical dysplasia and cancer due to their immunocompromised status. However, the literature is not clear if these patients are at equal risk. The objective of the study is to compare PAP smear results as well has histopathology findings in these two populations. METHODS: A retrospective chart review of colposcopy patients seen at SUNY Downstate Medical Center with a history of HIV or Renal Transplant was performed. Each patient’s index PAP and colposcopy results were reviewed. RESULTS: A total of 61 HIV patients and 11 Renal Transplant patients were included. 29.5% (18/61) of HIV patients had an initial PAP result of ASCUS and 33% (6/18) of these patients had biopsies positive for precancerous lesions ranging from CIN 1 - 3. 54% (33/61) of HIV patients had an initial PAP of LSIL and 42% (14/33) of these patients had positive biopsy results. 10% (6/61) had an initial PAP of HSIL or ASC-H and 100% of these patients had precancerous lesions (CIN 1-3) or cervical cancer (1/6). Of the 11 Renal Transplant patients, 5/11 presented with ASCUS and 6/11 had LSIL. Only 3/11 had histopathology and all had CIN 1. CONCLUSION: An analysis of PAP smear results in these two populations reveals that HIV patients tend to have PAP smears of a higher grade with a higher incidence of dysplasia as compared to Renal Transplant patients. The reason for this is unclear but may be due to the underlying reasons for the immunocompromised state.