Aserlind Alexandra, Maguire Karla, Duthely Lunthita, Wennin Stefan, Potter JoNell
University of Miami Miller School of Medicine, Department of Obstetrics & Gynecology, Miami, FL, USA.
Infect Dis Obstet Gynecol. 2017;2017:2105061. doi: 10.1155/2017/2105061. Epub 2017 Sep 17.
Women living with HIV are at increased risk of human papillomavirus (HPV) infection, which can lead to cervical cancer. New guidelines recommend indefinite screening. The objective of this study is to describe cervical cancer screening practices and colposcopy results in a cohort of women living with HIV over age of 65 who were followed before the new guidelines. Comorbidities, sexually transmitted infections (STIs), and other risk factors were evaluated.
We conducted a retrospective chart review on 75 women aged 65 or older living with HIV with at least one Pap smear.
The mean age of the cohort was 66.5 and at HIV diagnosis was 56. The majority of women were immunocompetent. 80% had serial Pap smears. Of these, 86% of 238 were negative or ASCUS. No women progressed to HSIL. 92% of colposcopies had negative or CIN I results. Three women were treated successfully for high-grade dysplasia. More than half of women had other STIs. 72% were screened for HPV; 50% were positive.
The majority of women had negative and low-grade Pap smears. Questions remain regarding the utility of continued Pap screening and the added value of HPV testing in this unique population of older women living with HIV.
感染人类免疫缺陷病毒（HIV）的女性感染人乳头瘤病毒（HPV）的风险增加，而HPV感染可导致宫颈癌。新指南建议进行无限期筛查。本研究的目的是描述在新指南发布之前接受随访的65岁以上HIV感染女性队列中的宫颈癌筛查实践和阴道镜检查结果。对合并症、性传播感染（STIs）及其他风险因素进行了评估。
我们对75名65岁及以上且至少进行过一次巴氏涂片检查的HIV感染女性进行了回顾性病历审查。
该队列的平均年龄为66.5岁，确诊HIV时的平均年龄为56岁。大多数女性免疫功能正常。80%的女性进行了系列巴氏涂片检查。其中，238例中有86%为阴性或意义不明确的不典型鳞状细胞（ASCUS）。没有女性进展为高级别鳞状上皮内病变（HSIL）。92%的阴道镜检查结果为阴性或宫颈上皮内瘤变I级（CIN I）。3名女性的高级别发育异常得到成功治疗。超过一半的女性患有其他性传播感染。72%的女性接受了HPV检测；50%呈阳性。
大多数女性的巴氏涂片检查结果为阴性和低级别病变。对于这一独特的老年HIV感染女性群体，继续进行巴氏涂片筛查的效用以及HPV检测的附加价值仍存在疑问。
