       Document 0488
 DOCN  M9610488
 TI    Cervical dysplasia in HIV-seropositive women: role of human
       papillomavirus infection and immune status.
 DT    9601
 AU    Garzetti GG; Ciavattini A; Butini L; Vecchi A; Montroni M; Institute of
       Obstetrics and Gynecology, University of Ancona,; Italy.
 SO    Gynecol Obstet Invest. 1995;40(1):52-6. Unique Identifier : AIDSLINE
       MED/96018424
 AB    OBJECTIVE: In the present study we investigated the cytologic and
       colposcopic characteristics of a cohort of HIV-infected women, with the
       aim to determine a relationship between immunologic status and frequency
       and/or severity of cervical abnormalities. MATERIALS AND METHODS: 21
       women, who tested positive for the HIV antibody and who were admitted as
       outpatients because of various gynecologic complications or because of
       an HIV infection that was under regular clinical surveillance. A pelvic
       examination was performed and Papanicolaou smears were obtained from
       endocervix and ectocervix before colposcopic examination. Cytologic
       samples for human papillomavirus (HPV) detection by polymerase chain
       reaction were also collected. Results obtained in the group of
       HIV-infected women were compared with findings in a group of 473
       seronegative women recruited consecutively from our outpatient
       population. Serum samples for T lymphocytes were drawn within 2 weeks of
       cytologic and colposcopic examination. CD4 and CD8 monoclonal antibodies
       were purchased from Becton Dickinson (Mountain View, Calif., USA).
       RESULTS: HIV-infected women had a significantly higher percentage of HPV
       DNA positivity with respect to the outpatient population (67 vs. 7%,
       respectively, p < 0.001). Analysis of cytologic specimens revealed 9
       women (43%) with cytologic evidence of cervical dysplasia in the
       HIV-seropositive group vs. 23 (5%) of 473 in the outpatient population
       (p < 0.001). All the HIV-seropositive women with cervical dysplasia
       presented an associated HPV DNA positivity; in particular, the
       percentage of associated HPV DNA type 16 in cervical dysplasia was 78%
       (7/9 cases). In HIV-infected women, the evaluation of T lymphocyte
       subset distribution suggested a significant relationship between CD4+
       cell decrease and severity of cytologic findings (p = 0.03). DISCUSSION:
       The HIV-infected women had a tenfold higher prevalence of both HPV
       infection and cervical dysplasia than the outpatient population; this
       increased risk seems to be limited mainly to those who also had genital
       HPV infection. The analysis of immunologic status confirmed previous
       observations that an impaired immune system results in increased
       cervical disease.
 DE    Adult  Base Sequence  Cervix
       Dysplasia/COMPLICATIONS/IMMUNOLOGY/*VIROLOGY  Cohort Studies  CD4
       Lymphocyte Count  DNA, Viral/ISOLATION & PURIF  Female  Human  HIV
       Seropositivity/COMPLICATIONS/*IMMUNOLOGY/*VIROLOGY  Molecular Sequence
       Data  Papillomavirus, Human/*ISOLATION & PURIF  Papovaviridae
       Infections/*IMMUNOLOGY/*VIROLOGY  JOURNAL ARTICLE

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

