Abstract
Introduction: South Africa (SA) has more people living with Human Immunodeficiency Virus (HIV) than any other country in the world. Women infected with HIV have a higher risk of developing cervical dysplasia and cancer than women who are not infected.Objective: To ascertain the correlation between the World Health Organisation (WHO) HIV staging and adherence to highly active antiretroviral therapy (HAART) with abnormal Pap smear results of HIV-infected women attending a government hospital in Johannesburg, SA.Methods: A cross-sectional descriptive study was performed by reviewing Pap smears of 390 HIV-positive women. Adherence was measured by the patient’s report and viral load. Data was collected through the use of self-administered questionnaires.Results: The prevalence of abnormal Pap smears was 57% and low grade squamous intraepithelial lesions (LGSIL) were the most common abnormality seen (142/390, 36%). WHO stage 3 participants were three times more likely to have abnormal Pap smears than those with WHO stage 1 (OR 3.3, 95% CI 1.23-9.04, p = 0.018). Abnormal Pap smears were seen more frequently in participants with a CD4 cell count ≤ 350 cells/μl compared to participants with CD4 cell count ≥ 500 cells/μl (p = 0.001, 95% CI 0.09-0.37). Participants who did not use HAART had more abnormal results compared to those who used HAART (p 0.028, 95% CI 0.28-0.93). Self-reported adherence to HAART did not show any association with abnormal Pap smears.Conclusion: Increased immune-suppression measured by WHO staging or CD4 count increases the risk of cervical cancer precursors. The high risk group in this study was found to be participants with CD4 350 cells/μl.
Highlights
South Africa (SA) has more people living with Human Immunodeficiency Virus (HIV) than any other country in the world
Eighty-four percent (328/390, 84%) of participants were stage 1 according to the World Health Organisation (WHO) HIV classification system and the median CD4 count for the study was 381 cells/μl
The majority of women were using highly active antiretroviral therapy (HAART) (330/390, 85%; 15% of other participants were in pre-initiation phase) and 51% (198/390) of the participants had a viral load below 50 copies/ml
Summary
South Africa (SA) has more people living with Human Immunodeficiency Virus (HIV) than any other country in the world. Sub-Saharan Africa, a region with only 12% of the global population, has 68% of all people living with human immunodeficiency virus (HIV), with women constituting greater than 50% of the epidemic.[1] The epidemic continues to be most severe in southern Africa, with South Africa having more people living with HIV (an estimated 5.6 million) than any other country in the world.[1] Women infected with HIV have a high risk of developing cervical dysplasia and cancer of the cervix than women who are not infected.[2] Cervical cancer is the second most common cause of cancer mortality in women worldwide, and the leading cause of cancer mortality in African women, where access to screening programmes is limited.[1,2,3]. Cervical cancer is a preventable condition and Papanicolaou test is a screening tool for the early detection of cervical cancer.[6,7] The Pap smear screening method has been shown to reduce mortality from cervical cancer.[8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
