Prevalence and predictors of squamous cell abnormalities in Papanicolaou smears from women infected with HIV-1

L. Stewart Massad, Katherine A. Riester, Kathryn Anastos, Rachel G. Fruchter, Joel M. Palefsky, Robert D. Burk, David Burns, Ruth M. Greenblatt, Laila I. Muderspach, Paolo Miotti

Research output: Contribution to journalArticle

159 Citations (Scopus)

Abstract

Background: Cervical neoplasia occurs with increased frequency among women infected with HIV-1. Objective: To characterize prevalence of and risk factors for abnormal cervical cytology among women with HIV and to compare them to uninfected women. Methods: Baseline cervical cytology was obtained from 1713 women seropositive for HIV and 482 at-risk control women who were enrolled in the Women's Interagency HIV Study, a multicenter prospective cohort study conducted in six U.S. cities. Associations with sociodemographic, medical, and sexual variables were assessed by Fisher's exact test, Mantel extension test, and logistic regression analysis. Results: Cervical cytology was abnormal in 38.3% of HIV-infected women (atypical squamous cells of uncertain significance [ASCUS] 20.9%, low-grade squamous cells of uncertain significance [LSIL] 14.9%, high-grade squamous cells of uncertain significance [HSIL] 2.3%, cancer 0.2%) and 16.2% of HIV-uninfected women (ASCUS 12.7%, LSIL 2.3%, HSIL 1.2%, cancer 0.0%). Risk factors for any abnormal cytology in multivariate analysis included HIV infection, CD4 cell count, HIV RNA level, detection of human papillomavirus (HPV), a prior history of abnormal cytology, employment, and number of male sex partners within 6 months of enrollment. Prior abortion was associated with a decreased risk of cytologic abnormality. Conclusions: Cervical cytologic abnormalities were frequent among women infected with HIV, although high-grade changes were found in only 2.5%. Factors linked to sexual and reproductive history, HPV infection, and HIV disease all influenced risk.

Original languageEnglish (US)
Pages (from-to)33-41
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Volume21
Issue number1
StatePublished - May 1 1999

Fingerprint

Papanicolaou Test
HIV-1
Epithelial Cells
HIV
Cell Biology
Neoplasms
Reproductive History
Papillomavirus Infections
CD4 Lymphocyte Count
Multicenter Studies
HIV Infections
Cohort Studies
Multivariate Analysis
Logistic Models
Regression Analysis
Prospective Studies
RNA

Keywords

  • Cytology
  • HIV
  • Screening
  • Squamous intraepithelial lesion

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Virology

Cite this

Prevalence and predictors of squamous cell abnormalities in Papanicolaou smears from women infected with HIV-1. / Massad, L. Stewart; Riester, Katherine A.; Anastos, Kathryn; Fruchter, Rachel G.; Palefsky, Joel M.; Burk, Robert D.; Burns, David; Greenblatt, Ruth M.; Muderspach, Laila I.; Miotti, Paolo.

In: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, Vol. 21, No. 1, 01.05.1999, p. 33-41.

Research output: Contribution to journalArticle

Massad, LS, Riester, KA, Anastos, K, Fruchter, RG, Palefsky, JM, Burk, RD, Burns, D, Greenblatt, RM, Muderspach, LI & Miotti, P 1999, 'Prevalence and predictors of squamous cell abnormalities in Papanicolaou smears from women infected with HIV-1', Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, vol. 21, no. 1, pp. 33-41.
Massad, L. Stewart ; Riester, Katherine A. ; Anastos, Kathryn ; Fruchter, Rachel G. ; Palefsky, Joel M. ; Burk, Robert D. ; Burns, David ; Greenblatt, Ruth M. ; Muderspach, Laila I. ; Miotti, Paolo. / Prevalence and predictors of squamous cell abnormalities in Papanicolaou smears from women infected with HIV-1. In: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology. 1999 ; Vol. 21, No. 1. pp. 33-41.
@article{7aab92262d824ccc80829caa3a66bf23,
title = "Prevalence and predictors of squamous cell abnormalities in Papanicolaou smears from women infected with HIV-1",
abstract = "Background: Cervical neoplasia occurs with increased frequency among women infected with HIV-1. Objective: To characterize prevalence of and risk factors for abnormal cervical cytology among women with HIV and to compare them to uninfected women. Methods: Baseline cervical cytology was obtained from 1713 women seropositive for HIV and 482 at-risk control women who were enrolled in the Women's Interagency HIV Study, a multicenter prospective cohort study conducted in six U.S. cities. Associations with sociodemographic, medical, and sexual variables were assessed by Fisher's exact test, Mantel extension test, and logistic regression analysis. Results: Cervical cytology was abnormal in 38.3{\%} of HIV-infected women (atypical squamous cells of uncertain significance [ASCUS] 20.9{\%}, low-grade squamous cells of uncertain significance [LSIL] 14.9{\%}, high-grade squamous cells of uncertain significance [HSIL] 2.3{\%}, cancer 0.2{\%}) and 16.2{\%} of HIV-uninfected women (ASCUS 12.7{\%}, LSIL 2.3{\%}, HSIL 1.2{\%}, cancer 0.0{\%}). Risk factors for any abnormal cytology in multivariate analysis included HIV infection, CD4 cell count, HIV RNA level, detection of human papillomavirus (HPV), a prior history of abnormal cytology, employment, and number of male sex partners within 6 months of enrollment. Prior abortion was associated with a decreased risk of cytologic abnormality. Conclusions: Cervical cytologic abnormalities were frequent among women infected with HIV, although high-grade changes were found in only 2.5{\%}. Factors linked to sexual and reproductive history, HPV infection, and HIV disease all influenced risk.",
keywords = "Cytology, HIV, Screening, Squamous intraepithelial lesion",
author = "Massad, {L. Stewart} and Riester, {Katherine A.} and Kathryn Anastos and Fruchter, {Rachel G.} and Palefsky, {Joel M.} and Burk, {Robert D.} and David Burns and Greenblatt, {Ruth M.} and Muderspach, {Laila I.} and Paolo Miotti",
year = "1999",
month = "5",
day = "1",
language = "English (US)",
volume = "21",
pages = "33--41",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Prevalence and predictors of squamous cell abnormalities in Papanicolaou smears from women infected with HIV-1

AU - Massad, L. Stewart

AU - Riester, Katherine A.

AU - Anastos, Kathryn

AU - Fruchter, Rachel G.

AU - Palefsky, Joel M.

AU - Burk, Robert D.

AU - Burns, David

AU - Greenblatt, Ruth M.

AU - Muderspach, Laila I.

AU - Miotti, Paolo

PY - 1999/5/1

Y1 - 1999/5/1

N2 - Background: Cervical neoplasia occurs with increased frequency among women infected with HIV-1. Objective: To characterize prevalence of and risk factors for abnormal cervical cytology among women with HIV and to compare them to uninfected women. Methods: Baseline cervical cytology was obtained from 1713 women seropositive for HIV and 482 at-risk control women who were enrolled in the Women's Interagency HIV Study, a multicenter prospective cohort study conducted in six U.S. cities. Associations with sociodemographic, medical, and sexual variables were assessed by Fisher's exact test, Mantel extension test, and logistic regression analysis. Results: Cervical cytology was abnormal in 38.3% of HIV-infected women (atypical squamous cells of uncertain significance [ASCUS] 20.9%, low-grade squamous cells of uncertain significance [LSIL] 14.9%, high-grade squamous cells of uncertain significance [HSIL] 2.3%, cancer 0.2%) and 16.2% of HIV-uninfected women (ASCUS 12.7%, LSIL 2.3%, HSIL 1.2%, cancer 0.0%). Risk factors for any abnormal cytology in multivariate analysis included HIV infection, CD4 cell count, HIV RNA level, detection of human papillomavirus (HPV), a prior history of abnormal cytology, employment, and number of male sex partners within 6 months of enrollment. Prior abortion was associated with a decreased risk of cytologic abnormality. Conclusions: Cervical cytologic abnormalities were frequent among women infected with HIV, although high-grade changes were found in only 2.5%. Factors linked to sexual and reproductive history, HPV infection, and HIV disease all influenced risk.

AB - Background: Cervical neoplasia occurs with increased frequency among women infected with HIV-1. Objective: To characterize prevalence of and risk factors for abnormal cervical cytology among women with HIV and to compare them to uninfected women. Methods: Baseline cervical cytology was obtained from 1713 women seropositive for HIV and 482 at-risk control women who were enrolled in the Women's Interagency HIV Study, a multicenter prospective cohort study conducted in six U.S. cities. Associations with sociodemographic, medical, and sexual variables were assessed by Fisher's exact test, Mantel extension test, and logistic regression analysis. Results: Cervical cytology was abnormal in 38.3% of HIV-infected women (atypical squamous cells of uncertain significance [ASCUS] 20.9%, low-grade squamous cells of uncertain significance [LSIL] 14.9%, high-grade squamous cells of uncertain significance [HSIL] 2.3%, cancer 0.2%) and 16.2% of HIV-uninfected women (ASCUS 12.7%, LSIL 2.3%, HSIL 1.2%, cancer 0.0%). Risk factors for any abnormal cytology in multivariate analysis included HIV infection, CD4 cell count, HIV RNA level, detection of human papillomavirus (HPV), a prior history of abnormal cytology, employment, and number of male sex partners within 6 months of enrollment. Prior abortion was associated with a decreased risk of cytologic abnormality. Conclusions: Cervical cytologic abnormalities were frequent among women infected with HIV, although high-grade changes were found in only 2.5%. Factors linked to sexual and reproductive history, HPV infection, and HIV disease all influenced risk.

KW - Cytology

KW - HIV

KW - Screening

KW - Squamous intraepithelial lesion

UR - http://www.scopus.com/inward/record.url?scp=0033135498&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033135498&partnerID=8YFLogxK

M3 - Article

C2 - 10235512

AN - SCOPUS:0033135498

VL - 21

SP - 33

EP - 41

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 1

ER -