Cytological Abnormalities and its Relation to CD4 Count among HIV Seropositive Women Living in Ahvaz, Southwest of Iran

Abstract

Introduction: Human immunodeficiency virus (HIV) infection is a well-established risk factor for abnormal cervical cytology and cervical cancer. This study aims to investigate cervical cytological abnormalities and their relationship with CD4 (T4 Lymphocyte) counts among HIV-seropositive women.

Methods: A study was conducted on 58 HIV-positive women referred to the Ahvaz Counseling Center for Behavioral Disease in southwest Iran between 2016 and 2017. Pap smears were performed on all participants from the cervix and endocervix. Patient characteristics, including age, duration of disease, anti-retroviral treatment (ART), marital status, number of children, and contraception methods, were recorded. Cervical cytological abnormalities were reported using the Bethesda system (TBS). A regular blood sample was taken from all patients to evaluate CD4 cell counts. Logistic regression models were employed to determine the odds ratio (OR) for the presence of cytological abnormalities in relation to CD4 counts while controlling for important factors.

Results: Among the 58 patients, only 5 were not receiving ART. The study revealed that 29.3% of patients exhibited squamous cell abnormalities, with a higher prevalence observed among patients aged 30-40 years (70.6%). The prevalence of ASC-US (Atypical Squamous Cells of Undetermined Significance), LSIL (Low-Grade Squamous Intraepithelial Lesions), and HSIL (High-Grade Squamous Intraepithelial Lesions) were 19.0%, 3.4%, and 6.9%, respectively. Overall, 9 patients required a repeat Pap smear test. The presence of cervical cytological abnormalities was not associated with CD4 counts, even after adjusting for variables such as age, duration of disease, and ART.

Conclusion: A high prevalence of ASC-US was found in HIV-infected women, and this prevalence was independent of age, duration of disease, and ART history. Therefore, cervical cancer screening in this population could have significant public health benefits.