International Journal of STD & AIDS > Volume 19, Number 8 > Pp. 529-532

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Mangclaviraj, S. Articles by Phanuphak, P. PubMed PubMed Citation Social Bookmarking                      What's this?

Original research articles

Nadir CD4 count and monthly income predict cervical squamous cell abnormalities in HIV-positive women in a resource-limited setting

Somsamorn Mangclaviraj MD ^*, Stephen J Kerr MIPH PhD  ^** , Surasith Chaithongwongwatthana MD , Jintanat Ananworanich MD  , Bernard Hirschel MD , Sean Emery PhD ^**, David A Cooper MD Dsc ^**, Pichai Chotnopparatpattara MD , Kiat Ruxrungtham MD MSc ^* and Praphan Phanuphak MD PhD ^* 

^* Thai Red Cross AIDS Research Centre, 104 Ratchadamri Road; HIV-Netherlands-Australia-Thailand Research Collaboration (HIV-NAT); Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Geneva University Hospital, Geneva, Switzerland; ^** National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia; South East Asia Research Collaboration with Hawaii (SEARCH), Bangkok, Thailand

Correspondence to: Dr Stephen J Kerr Email: Stephen.k{at}hivnat.org

We conducted a cross-sectional study with 385 HIV-positive women in Bangkok to assess the prevalence and predictors of cervical abnormalities on Papanicolaou (Pap) smear. Low-grade squamous intraepithelial lesions (LSIL), high-grade SIL (HSIL) and invasive cervical cell cancer (ICC) were assessed by cytological examination after Pap smear and logistic regression models were used to assess associations with patient characteristics. Overall prevalence of LSIL, HSIL and ICC were 11.2% (95% confidence interval [CI] 8.2–14.7%), 4.7% (95%CI 2.8–7.3%) and 0.5% (95%CI 0.06–1.9%), respectively. In multivariate models, only the nadir CD4 count and income remained significantly associated with cytological abnormalities, whereas smoking, hormonal contraceptive or antiretroviral use, condom use, parity and number of lifetime sexual partners were not associated. The odds ratio for having cytological abnormalities was 2.6 (95% CI 1.24–5.34) in those with a nadir CD4 count <200 cells/mm³ compared with those with a higher nadir CD4 count, and 1.99 (1.11–3.57) in those with an income of <125 US dollars/month compared with those with higher incomes. In settings where access to affordable treatment is improving, this study reinforces the importance of regular Pap smear screening in HIV-positive women, particularly those with low nadir CD4 counts and lower incomes.

Key Words: women's health • HIV infection • squamous intraepithelial lesion • resource-limited setting

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?