Original article / research
Cervical Dysplasia among Women Living with HIV: A Comparative Accuracy of Different Screening Methods
QC20-QC24
Correspondence
Sushruta Shrivastava,
E6/105, Arera Colony Behind Seven Hills School, Bhopal, Madhya Pradesh, India.
E-mail: vikrantsush18@gmail.com
Introduction: Cervical cancer remains a significant public health concern, particularly among women living with Human Immunodeficiency Virus (HIV), due to the synergistic role of HIV in promoting high-risk Human Papillomavirus (HPV)-induced carcinogenesis. Early detection through effective screening methods is crucial to reduce morbidity and mortality.
Aim: To determine the prevalence of cervical dysplasia and associated risk factors in HIV-positive females, and to compare the diagnostic accuracy of conventional cytology with alternative cervical screening methods.
Materials and Methods: The present cross-sectional study was conducted at Gandhi Medical College from 1st August 2020 to 31st July 2021 after obtaining ethical clearance from the institute. A total of 250 HIV-positive females registered at the Antiretroviral Therapy (ART) Centre underwent cervical screening using conventional Papanicolaou (Pap) Smear, Liquid-Based Cytology (LBC), Visual Inspection With Acetic Acid (VIA), and Visual Inspection With Lugol’s Iodine (VILI). Data were compiled using Microsoft Excel and analysed using IBM Statistical Package for Social Sciences (SPSS) software version 20. Categorical data were presented as frequency and percentage, whereas continuous data were expressed as mean±standard deviation.
Results: The mean age of the study participants was 38.01±9.18 years. Only 8 (3.2%) participants were aware of cervical screening, highlighting a critical gap in awareness. Risk factors significantly associated with abnormal cytology included age between 30-49 years, late menopause (46-50 years), higher parity, and CD4 count<500 (p<0.05). Liquid-Based Cytology demonstrated the highest sensitivity (100%) and negative predictive value, outperforming other screening methods. VIA and VILI showed positive findings in 16 (6.4%) and 9 (3.6%) cases, respectively, with VILI showing the highest specificity.
Conclusion: Cervical dysplasia was detected in 9.6% of screened HIV-positive women (24 out of 250 women), highlighting a substantial burden of pre-invasive disease. The findings underscore the value of regular cervical screening using Pap smear, LBC, VIA, and VILI as effective tools for early detection. Integrating cervical cancer screening into routine HIV care and improving awareness among women living with HIV may substantially reduce HPV-related morbidity and mortality.