The Value of Cervical Cytology in HIV-Infected Women

Giuseppe Del Priore, Terry Maag, Mondira Bhattacharya, Patricia M. Garcia, Michele Till, John R. Lurain

Research output: Contribution to journalArticle

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Abstract

The purpose of this study was to assess the ability of cytology to predict the results of colposcopically directed cervical biopsies in HIV-infected women. We performed a case-control study of 52 HIV(+), 31% of whom had AIDS, and 57 HIV(-) women referred to two tertiary care centers for colposcopy from July 1991 to November 1993. All 57 HIV(-) controls and 27 HIV(+) cases underwent colposcopy for evaluation of an abnormal Pap smear. The remaining HIV(+) cases (n = 25) had colposcopy as part of their routine assessment. In women with abnormal Pap smears, colposcopic biopsy agreed with the Pap smear results in 83% of 24 HIV(+) women and 65% of 37 controls (χ2; P = 0.34). For patients with low-grade SIL on Pap smear, 14% of HIV(+) and 11% of HIV(-) women had moderate or severe dysplasia on biopsy (P = 0.52). The positive predictive value of an abnormal Pap smear was 96% in HIV(+) women vs 78% in noninfected patients (P = 0.05). In the overall series of 52 HIV(+) women, the Pap smear did not match the biopsy in 44% of patients and was less severe than the cervical biopsy results in 91% of these mismatches. The Pap smear had a sensitivity of 57%, a specificity of 92%, a positive predictive value of 96%, and a negative predictive value of 39%, when compared to biopsy results in HIV-seropositive patients. Pap smears missed 43% of biopsy-proven intraepithelial lesions in this series of HIV(+) women. However, when abnormal, the Pap smear was no worse in predicting the presence and degree of an intraepithelial lesion in HIV(+) women than in noninfected women. These characteristics may justify immediate treatment of HIV(+) women at the time of colposcopy after an abnormal Pap smear given its high positive predictive value.

Original languageEnglish (US)
Pages (from-to)395-398
Number of pages4
JournalGynecologic Oncology
Volume56
Issue number3
DOIs
StatePublished - Mar 1995
Externally publishedYes

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Cell Biology
Papanicolaou Test
HIV
Colposcopy
Biopsy
Tertiary Care Centers
Case-Control Studies
Acquired Immunodeficiency Syndrome

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

Del Priore, G., Maag, T., Bhattacharya, M., Garcia, P. M., Till, M., & Lurain, J. R. (1995). The Value of Cervical Cytology in HIV-Infected Women. Gynecologic Oncology, 56(3), 395-398. https://doi.org/10.1006/gyno.1995.1069

The Value of Cervical Cytology in HIV-Infected Women. / Del Priore, Giuseppe; Maag, Terry; Bhattacharya, Mondira; Garcia, Patricia M.; Till, Michele; Lurain, John R.

In: Gynecologic Oncology, Vol. 56, No. 3, 03.1995, p. 395-398.

Research output: Contribution to journalArticle

Del Priore, G, Maag, T, Bhattacharya, M, Garcia, PM, Till, M & Lurain, JR 1995, 'The Value of Cervical Cytology in HIV-Infected Women', Gynecologic Oncology, vol. 56, no. 3, pp. 395-398. https://doi.org/10.1006/gyno.1995.1069
Del Priore G, Maag T, Bhattacharya M, Garcia PM, Till M, Lurain JR. The Value of Cervical Cytology in HIV-Infected Women. Gynecologic Oncology. 1995 Mar;56(3):395-398. https://doi.org/10.1006/gyno.1995.1069
Del Priore, Giuseppe ; Maag, Terry ; Bhattacharya, Mondira ; Garcia, Patricia M. ; Till, Michele ; Lurain, John R. / The Value of Cervical Cytology in HIV-Infected Women. In: Gynecologic Oncology. 1995 ; Vol. 56, No. 3. pp. 395-398.
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