Cervical screening in HIV-positive women in the East of England: recent CD4 as the predictive risk factor. (November 2015)

• Record Type: Journal Article
• Authors: Davies, Olubanke; Rajamanoharan, Sasikala; Balachandran, Thambiah
• Is Part Of: International journal of STD & AIDS. Volume 26:Number 13(2015)
• Page Start: 945
• Page End: 950
• Publication Date: 2015-11
• Subjects: HAART -- cervical dysplasia -- HIV -- AIDS -- women -- SIL -- CIN -- screening; Sexually transmitted diseases -- Periodicals; AIDS (Disease) -- Periodicals; 616.951
• DOI: 10.1177/0956462414563624
• Languages: English
• ISSNs: 0956-4624

Abstract

This study examines the relationship between CD4 count and cervical cytological abnormality in HIV-positive women attending two district general hospital genitourinary medicine clinics in the East of England. It aims to determine whether the rate of cervical cytological abnormalities differs in HIV-positive women with CD4 count >350 cells/µl and those with CD4 count ≤350 cells/µl; and to compare the rates of abnormalities with that of the general population. We retrospectively reviewed data from a cross-sectional audit undertaken between December 2010 and December 2011 and analysed them using multivariable statistics. There was a significant association between recent CD4 count ≤350 cells/µl and cervical cytological abnormality (p < 0.001). A total of 6.3% of women with recent CD4 counts >350 cells/µl had abnormal cervical smear results, compared with 6.6% of the general population in the screening period 2010–11 and 7.2% of the general population in the screening period 2009–10. In our study population of women with recent CD4 counts >350 cells/µl, the proportions of mild, moderate and severe dysplasia were also similar to national figures. This raises important questions about the cost effectiveness of blanket annual screening for HIV-positive women.