       Document 0299
 DOCN  M9440299
 TI    Cervicovaginal screening in women with HIV infection: a need for
       increased vigilance?
 DT    9404
 AU    Hankins CA; Lamont JA; Handley MA; Centre for AIDS Studies, Montreal
       Regional Public Health Team,; Public Health Unit, Montreal General
       Hospital, PQ.
 SO    Can Med Assoc J. 1994 Mar 1;150(5):681-6. Unique Identifier : AIDSLINE
       MED/94147302
 AB    OBJECTIVE: To review the current literature on cervical disease
       (dysplasia, cervical intraepithelial neoplasia [CIN] or carcinoma) in
       women with HIV infection and to assess recommendations for
       cervicovaginal screening in these patients. DATA SOURCES: MEDLINE and
       AIDSLINE were searched for relevant articles published in English or
       French between January 1987 and February 1993, abstracts presented at
       international AIDS conferences from 1989 to 1993 were evaluated, and
       pertinent agencies and organizations were consulted. STUDY SELECTION: A
       total of 92 reports of gynecologic disease in women with HIV infection
       were examined; 32 studies were retained that reported pertinent findings
       on cervical dysplasia, CIN or cervical carcinoma. DATA EXTRACTION: The
       following criteria were used to extract data: study design (descriptive
       v. comparative), sample size, heterogeneity of the study population,
       presence of immunodeficiency indicators (i.e., absolute CD4+ lymphocyte
       count) and presence of concomitant vaginal infections. Recommendations
       were assessed for their specific application to women with HIV
       infection. DATA SYNTHESIS: Data on the associations between stage of
       cervical disease and response to treatment at varying levels of CD4+
       lymphocyte depletion were incomplete. Recommendations by official bodies
       for cervicovaginal screening in women with HIV infection differed little
       from recommendations for standard care of all women of reproductive age.
       CONCLUSIONS: The consequences of a missed or delayed diagnosis of
       cervical disease for women with HIV infection can be severe. Pending
       further research, more frequent cervicovaginal screening through
       Papanicolaou testing and colposcopy in women with HIV infection is
       warranted.
 DE    Adult  Canada  Carcinoma in Situ/*DIAGNOSIS/ETIOLOGY  Cervical
       Intraepithelial Neoplasia/*DIAGNOSIS/ETIOLOGY  Cervix
       Dysplasia/*DIAGNOSIS/ETIOLOGY  Cervix Neoplasms/*DIAGNOSIS/ETIOLOGY
       Female  Human  HIV Infections/*COMPLICATIONS  Practice Guidelines
       Support, Non-U.S. Gov't  Vaginal Smears  JOURNAL ARTICLE  REVIEW  REVIEW
       LITERATURE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

