Gupta, kritika and Philipose, Cheryl Sarah and Kaur, Gagandeep and Kini, Hema and *, Chaithra G V and Adiga, Deepa S (2019) A Study of Pap Smears in HIV positive and negative women from a tertiary care center in south India. Acta Cytologica., 63 (1). pp. 50-55. ISSN 0001-5547

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Abstract

Objectives: To study the spectrum of epithelial abnormalities on Pap smears of HIV positive women categorized as per the BSRTC; to correlate it with CD4 lymphocyte counts & to compare it with the spectrum of abnormalities seen in the HIV negative control group. Study Design and Methodology: The present study was a 6 year retrospective study conducted in the Department of Pathology at Kasturba Medical College, Mangalore, which included 150 Pap smears from HIV positive and HIV negative women respectively. The Pap stained slides of the cases were retrieved and studied. The data collected was tabulated and analyzed. Statistical study was performed using the SPSS software. Chi-square test was used to analyze the data and a p value of <0.05 was considered to be significant. Results: Pap smear abnormalities were twice as high in HIV infected women (12%) as compared to HIV negative women (6%), p= 0.006, [RR=2]. NILM was the commonest finding (88 %) which was further subdivided into inflammatory, atrophic smears, non-pecific, candidiasis and bacterial vaginitis. The percentage of epithelial abnormalities was 12 %: ASCUS- 5.55%, ASC-H—16.66 %, LSIL—5.55%, HSIL—61.11 % and SCC—11.11%. The highest incidence of intraepithelial lesions in HIV-positive females was in the age group 34–49 years. CD4 cell counts fell in the range of 200-500 cells/cumm in most of the HIV positive patients (68.75%), but was not found to be statistically significant. Conclusion: Routine Pap smear examination is advocated in women with HIV, as prevalence of epithelial cell abnormalities has been found to be 12%, which was twice as high as compared to HIV negative control group. Although there was no correlation of epithelial cell abnormalities with CD4 counts, a higher rate of these were observed to have CD4 cell counts of 200-500 cells/cumm.

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