Incidence and risk factors of cervical dysplasia among human immune deficiency virus positive and human immune deficiency virus negative women at Aminu Kano Teaching Hospital

Abstract

Background: HIV infection is a risk factor for cervical cancer and both diseases are prevalent in Nigeria. HIV positive women are at greater risk of cervical dysplasia than HIV negative women which may be as a result of immunosupression, hence adding more burdens to their already worsening health condition. It has become relevant to screen these women early and refer for appropriate and effective therapeutic intervention. Objective: To compare the incidence and risk factors of cervical dysplasia among HIV positive and HIV negative women at Aminu Kano Teaching Hospital, Kano. Methods: This was a comparative cross sectional studyl, which involved HIV positive women attending HIV clinic and HIV negative women attending the gynecological clinic at Aminu Kano Teaching Hospital. A cohort of 150 consenting HIV- positive women not on HAART and 150 HIV- negative women, selected by systematic random sampling were sent for Pap smear examination. On the same day blood samples were taken from antecubital vein and sent for both CD4 count and viral load among the HIV positive group. A pretested questionnaire was administered to the women of both groups on same day to determine the presence or absence of risk factors of cervical dysplasia in them. The results obtained were recorded using proforma and analyses of risk factors of cervical dysplasia was done using Chi square test and Fisher exact test to compare variables between those with normal and abnormal smears and student t test to determine the relationship of lesions with CD4count and viral load among the HIV positive women. Results: The incidence of cervical dysplasia among HIV- positive women was 49 (32.7%) and was significantly higher than 12(8%) found among the HIV- negative. Age ≥ 35years and parity ≥5, early coitarche, multiple sexual partners, low-socioeconomic status, cigarette smoking did confer some risk of dysplasia however. This study also showed that among the HIV positive group, CD4 count was inversely associated with risk of cervical dysplasia and women with a CD4 count 500 cells/mm3. Conclusion: It Ais important to carryout cervical smear screening for HIV-positive women, especially those with a CD4 count