Cytological Abnormalities and its relation to CD4 count among HIV seropositive women living in Ahvaz, southwest of Iran

IntroductionHuman immunodeficiency virus (HIV) infection is a known risk factor for abnormal cervical cytology and cervical cancer. The aim of this study was to investigate cervical cytological abnormalities and its relation with CD4 (T4 Lymphocyte) count among HIV seropositive women. MethodsWe conducted a study on 58 HIV positive women referred to Ahvaz Counseling Center for Behavioral Disease, southwest of Iran between 2016 and 2017. Pap smear was performed for all participants from the cervix and endocervix. Patients characteristics including age, duration of disease, treatment with anti-retroviral treatment (ART), marital status, number of children, and contraception method were also recorded. Cervical cytological abnormalities reported as Bethesda system (TBS). A regular blood sample was taken from all the patients to evaluate the CD4 cells counts. Logistic regression models were used to obtain OR of presences of cytological abnormalities related to CD4 counts, controlling for important factors. ResultsOut of 58 patients only 5 were not under ART. We demonstrated that 29.3 % of patients had squamous cell abnormalities and these abnormalities, was more prevalent among 30-40 years old patients (70.6%). The prevalence of ASC-US (Atypical Squamous Cells of Undetermined Significance), LSIL (Low-Grade Squamous Intraepithelial Lesions) and HSIL (High-Grade Squamous Intraepithelial Lesions) were 19.0%, 3.4%, and 6.9% respectively. Overall 9 patients need to repeat Pap smear test. Presence of cervical cytological abnormalities was not associated with the CD4 count, even after adjusting for the variable such age, duration of disease and ART. ConclusionWe found a high prevalence of ASC-US in HIV-infected women which was independent of age, duration of diseases and history of ART. Though cervical cancer screening in this population might have a substantial public health benefit. Summary box- More than 70% of cervical cancers incidences associated with Genital HPV infections - Prevalent of Squamous cell abnormalities among HIV-infected women was about sex time more than general population - We demonstrated that squamous cell abnormalities are more prevalent in middle age women (30 to 40 years) - The high prevalence of Squamous cell abnormalities in HIV-infected women warrants the need for regular Pap smear screening