Prevalence of cervical cytology abnormalities among HIV infected women at Rwanda Military Hospital

Abstract

Objectives: To establish the prevalence of cervical cytology abnormalities, determine the correlation between CD4+ cell count and abnormal Pap smear, determine the correlation between WHO-HIV staging and abnormal pap smear among HIV infected women attending HIV clinic at Rwanda Military Hospital. Design: Cross-sectional descriptive study Setting: Rwanda Military Hospital Kigali, Rwanda Subjects: All HIV-positive women, 18-69 years who had been or were sexually active and were attending the HIV-clinic and consented to participate in the study. Results: Two hundred and ninety three women infected with HIV had cervical smear taken for cytology. Of the 293 women who were recruited for the study, cervical Squamous Intra epithelial Lesion (SIL) were present in 58 (20%). Of those with cervical SIL, 33 (56.89%) women had low-grade SIL, 15(25.86%) had Atypical Squamous Cells of Undetermined Significance (ASCUS), six (10.34%) had high-grade SIL, three (5.17%) had Squamous cell carcinoma ( SCC) and one (1.72%) had Atypical Glandular Cells of Undetermined Significance (AGUS). In the current study, use of ARV drugs was not associated with a reduction in the risk of cervical SIL Conclusion: A high prevalence of cervical SIL was found among HIV-infected women at Rwanda Military Hospital. Increased immune suppression was significantly associated with cervical SIL.