Abstract
It has been described that women infected with the human immunodeficiency virus (HIV) present more frequent cytological abnormalities in cervicovaginal smears, generally related to infection by human papillomavirus (HPV). The present work is a study of cervicovaginal smears of 147 HIV-seropositive women submitted to routine gynecological examinations. The smears were stained by the Papanicolaou method. Cytopathic effects of HPV were found in 38 (25.8%) cases. Nuclear atypias of cervical intraepithelial neoplasia (CIN) were evident in 36 (24.5%) of these cases: 27 (18.4%), CIN I; 6 (4.0%), CIN II and 3 (2.0%) CIN III. Also 2 (1.4%) invasive carcinomas and one (0.7%) endocervical dysplasia were found. Other agents observed were: Candida sp, 19 (12.9%) cases, Gardnerella vaginalis, 19 (12.9%), Trichomonas vaginalis, 13 (8.4%), Chlamydia trachomatis 5 (3.4%), Mobiluncus sp 2 (1.4%) and Herpes simplex virus 1 (0.7%). This study emphasizes the high frequency of HPV/CIN cervicovaginal abnormalities in HIV-seropositive in our population. It is possible that immunological factors and sexual promiscuity are involved in this phenomenon.
Highlights
There has been a general consensus that genital human papiIIomaviruses (HPV) playa major causal role in the development of cervical intraepithelial neoplasia or cervical cancer [2,9,11,12]
It has been described that women infected with human immunodefficiency virus (HIV) have genital HPV infections detected by southern blot, dot blot, and PCR more frequently than women without the HIV infection [2,3,12]
We found 38 (25.8%) cases with cytopathic effects of HPV, 36 being clearly eIN cases (27 cervical intraepithelial neoplasia (CIN) I, 6 CIN II and 3 CIN III)
Summary
There has been a general consensus that genital human papiIIomaviruses (HPV) playa major causal role in the development of cervical intraepithelial neoplasia or cervical cancer [2,9,11,12]. HPV types and risk factors, especially immune state, may play important roles [9]. It has been described that the risk of developing neoplastic changes in the cervix is greater in immunosuppressed women than in the general population. Acquired Immunodefficiency Syndrome (AIDS) is a risk factor for pre-neopl astic/neoplastic cervicovagi nal disorders as well for HPV infections, subclinical or symptomatic [2, 10]. Squamous cell atypia and cytological signs ofHPV infection were found in women seropositive for human immunodefficiency virus (HIV) at a significantly higher rate when compared to seronegative women (11 ). The smears were stained by the Papanicolaou method and analyzed to search for nuclear cytological abnormalities, HPV cytopathic effects and other agents
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