A comparative study of PAP smear abnormalities in  HIV sero–positive and normal women in north coastal AP

Aruna. G; Vani. I; Durga Kumari. P; Satyasri . K; Bhagya lakshmi. A

Volume : V, Issue : IV, April - 2016

A comparative study of PAP smear abnormalities in HIV sero–positive and normal women in north coastal AP

Aruna. G, Vani. I, Durga Kumari. P, Satyasri . K, Bhagya Lakshmi. A

Abstract :

Background : Cancer of cervix is the most common genital malignancy in women worldwide [1]. Though cervix is an easily accessible organ for examination and the disease has a prolonged latency period between HPV infection and invasive cancer, the incidence is increasing. The burden of invasive cancer cervix in India accounts for 25%of the global incidence.Screening for cancer cervix is becoming the need of the country�s health policy and should be taken up as a part of family welfare programmes. HIV /AIDS is a global pandemic with India in second position worldwide in having maximum number of people living with HIV and AIDS. [2]. 50% of people living with HIV and AIDS are women in their reproductive age . HIV/AIDS is an important risk factor for cancer cervix. The human papilloma virus and its association with pre–malignant and malignant disease of cervix is now well established. The cross linkage of HPV and HIV organisms is well hypothesized and researched. Therefore HIV seropositive cases stand vulnerable to HPV induced invasive cancers of cervix. PAP smear screening is most successful method of cancer screening. It can detect > than 98 % cases of cancer cervix in their premalignant stage. [3]. ACOG and FOGSI recommends annual screening for all women in their reproductive age (15–44) to undergo PAP smear screening for minimum 3 times. This statement applies more so for HIV/AIDS women. In this background, the study has undertaken in north coastal AP district Visakhapatnam, which has high prevalence of HIV. AIMS & OBJECTIVES : This is a cross –sectional comparative cohort study to assess the prevalence of PAP smear abnormalities in normal population and in female people living with HIV and AIDS (PLWHA). 50 women with HIV sero positivity were enrolled for PAP smear examination and the slides were studied by cyto pathology team. The results were compared another group of healthy women for whom PAP smears were taken in a screening camp. The scoring and abnormalities on PAP smears were reported as per modified Bethesda system. The results were analysed and tabulated. The prevalence of PAP smear abnormalities was found to be 18% which is 2.6 fold increased risk as compared to general population. Our study also showed an increased incidence of AGUS and ASCUS abnormalities higher in the study group. Age, CD4 count,HAART treatment status were also influencing the cytological abnormalities. Thus this study highlights the need for periodic examination of HIV sero positive women for screening with PAP smear examination since they comprise a high risk population for invasive cervical cancers.