Risk factors for squamous intraepithelial lesions on pap smear in women at risk for human immunodeficiency virus infection

Robert S. Klein, Gloria Y.F. Ho, Sten H. Vermund, Irene Fleming, Robert D. Burk

Research output: Contribution to journalArticle

89 Scopus citations


To determine risk factors for squamous intraepitheliallesions (SIL) on Pap smear, 253 women at risk for human immunodeficiency virus (HIV) infection had Pap smear, HIV antibody testing, CD4+ cell measurements, and human papillomavirus (HPV) genome detection by Southern blot hybridization. Associated with SIL (P <.05) on univariate analysis were genital HPV (SIL prevalence in HPV-positive subjects, 36.3%; odds ratio [OR], 9.3; 95% confidence interval [CI], 4.2-20.3) and HIV infection (SIL prevalence in seropositive subjects, 21.9%; OR, 2.5; 95% Cl, 1.2-5.1). No demographic or behavioral variables were associated with risk for SIL. Multivariate analyses identified genital HPV infection (OR, 6.78; 95% Cl, 2.9-15.7), detection of known high-risk HPV types (OR, 11.8; 95% CI, 4.1-34.1), strong HPV Southern blot signal strength (OR, 10.8; 95% CI, 3.5-33.7), and severe HIV-related immunosuppression (OR, 3.1; 95% CI, 1.04-9.5) as independent risk factors associated with SIL. Thus, severe immunosuppression due to HIV infection increases the risk for SIL mediated by HPV infection.

Original languageEnglish (US)
Pages (from-to)1404-1409
Number of pages6
JournalJournal of Infectious Diseases
Issue number6
Publication statusPublished - Dec 1994


ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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