Incidence of Cytological Abnormalities in Pap's Smear in HIV Positive Women

Aims and Objectives: The aim of present study is to estimate the frequency of abnormal PAP’s smears and mainly to detect precancerous and cancerous lesions as well as inflammatory lesions in HIV infected women. Methodology: Our study was a retrospective study of total 130 cases and PAP’s smears were examined in cytology section in Department of Pathology, BJ Medical College, Ahmedabad from 1st March 2017 to 31st August 2017. Both HIV positive and HIV negative patients were included in the study. 80 patients were HIV negative and 50 patients were HIV positive. The clinical history and relevant parameters were noted. All the smears were processed by a conventional method using Papanicolaou stain.  Results: Out of 130 cases, 118 cases were reported negative for intraepithelial lesions or malignancy (NILM). Five cases were positive for squamous intraepithelial lesions (SIL) out of which four were HIV positive. Seven cases were of atypical squamous cells of undetermined significance (ASCUS) out of which 5 were HIV positive. Three cases were showing bacterial vaginosis. 1 case was showing Trichomonas Vaginalis. 19 cases were showing changes of non-specific inflammation. 6 cases were showing atrophic changes.  Conclusion: HIV infected women are at more risk to develop cervical cytological abnormalities. The study revealed a maximum number of non-specific inflammatory smears followed by smears showing atrophic changes. Smears suspicious for malignancy (ASCUS) and smears showing squamous intraepithelial lesions (SIL) were more common in HIV positive patients. Thus regular PAP’s smears screening as recommended by National AIDS Control Organization (NACO) will help in early detection of cervical abnormalities in HIV positive women.