Cervical cytology pattern and human immunodeficiency virus serostatus of women seen in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria

Abstract

Background: Cervical cancer is the second most common cancer in women worldwide. Human immunodeficiency virus (HIV) has been suggested to be a cofactor in the association between human papillomavirus and cervical intraepithelial neoplasia (CIN). Aim: To determine the pattern of cervical cytology changes in women of different HIV status and characterise the sociodemographic factors that confound the changes seen. Methods: This was a cross-sectional comparative study. This study was conducted in Gynaecology Clinic of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Following informed consent, 272 HIV-positive (HIV+) and 275 HIV-negative (HIV−) women had questionnaires administered and Papanicolaou smears were taken. Results: The average age of the respondents was 32.6 ± 6.8 years (range: 15–49 years). Mean parity for HIV+ women was 3.28 and 3.36 for HIV− women while 70.8% of HIV+ women were married comparable with 72.7% in HIV− women. Twenty-nine per cent of HIV+ women had positive smears for CIN compared with 16.4% in those that were HIV−. This was statistically significant (odds ratio = 2.05, P = 0.001). The high-grade lesions (CIN II and CIN III) tended to be higher in the HIV+ women (11.4%) than the HIV− women (0.7%). Conclusion: HIV+ women in Zaria, Northern Nigeria, are at higher risk of severe cervical dysplasia compared with their counterparts who are HIV−. It is recommended that greater effort should be made to have an integrated reproductive healthcare service which includes cervical cytology within the HIV clinics.