Abnormal Vaginal Pap Test After Hysterectomy in Human Immunodeficiency Virus-Infected Women

Stephanie Smeltzer, Xiaoying Yu, Kathleen Schmeler, Judy Levison

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the prevalence of abnormal vaginal cytology and vaginal intraepithelial neoplasia (VAIN) and vaginal cancer in human immunodeficiency virus (HIV)-infected women with no history of abnormal cytologic screening who had a hysterectomy for conditions other than cervical dysplasia and cancer; and to explore the risk factors associated with VAIN and vaginal cancer.

METHODS: A retrospective cohort study was performed identifying 238 women between January 2000 to January 2015 with a history of HIV, previous hysterectomy, and no previous abnormal Pap tests. Medical records from patients with both HIV and history of hysterectomy were reviewed from Thomas Street Health Center and Northwest Community Health Center.

RESULTS: Among 238 women, 164(69%) had normal Pap test results, 12(5%) had results showing atypical cells of undermined significance and human papillomavirus-positive, 55(23.1%) had results showing low-grade squamous intraepithelial lesion, and 7(2.9%) had results showing high-grade squamous intraepithelial lesion. No demographic risk factor was associated with abnormal Pap test after hysterectomy. Median follow-up time for the Pap test was 16 years. Of those who underwent vaginal biopsies for an abnormal Pap test, 15(28%) were normal, 23(43%) were VAIN1, 9(16%) were VAIN2, and 7(13%) were VAIN3. No patients had invasive vaginal cancer.

CONCLUSION: Over 30% of HIV-infected women who had no pre-hysterectomy history of an abnormal Pap test had abnormal vaginal Pap tests. Among those who had vaginal biopsies, 29% had VAIN2 or VAIN3, suggesting that Pap tests post-hysterectomy in the HIV population may be indicated.

Original languageEnglish (US)
JournalObstetrics and Gynecology
Volume127
DOIs
StatePublished - May 1 2016
Externally publishedYes

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Papanicolaou Test
Hysterectomy
HIV
Vaginal Neoplasms
Uterine Cervical Dysplasia
Biopsy
Community Health Centers
Uterine Cervical Neoplasms
Medical Records
Cell Biology
Neoplasms
Cohort Studies
Retrospective Studies
Demography
Health

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Abnormal Vaginal Pap Test After Hysterectomy in Human Immunodeficiency Virus-Infected Women. / Smeltzer, Stephanie; Yu, Xiaoying; Schmeler, Kathleen; Levison, Judy.

In: Obstetrics and Gynecology, Vol. 127, 01.05.2016.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To evaluate the prevalence of abnormal vaginal cytology and vaginal intraepithelial neoplasia (VAIN) and vaginal cancer in human immunodeficiency virus (HIV)-infected women with no history of abnormal cytologic screening who had a hysterectomy for conditions other than cervical dysplasia and cancer; and to explore the risk factors associated with VAIN and vaginal cancer.METHODS: A retrospective cohort study was performed identifying 238 women between January 2000 to January 2015 with a history of HIV, previous hysterectomy, and no previous abnormal Pap tests. Medical records from patients with both HIV and history of hysterectomy were reviewed from Thomas Street Health Center and Northwest Community Health Center.RESULTS: Among 238 women, 164(69{\%}) had normal Pap test results, 12(5{\%}) had results showing atypical cells of undermined significance and human papillomavirus-positive, 55(23.1{\%}) had results showing low-grade squamous intraepithelial lesion, and 7(2.9{\%}) had results showing high-grade squamous intraepithelial lesion. No demographic risk factor was associated with abnormal Pap test after hysterectomy. Median follow-up time for the Pap test was 16 years. Of those who underwent vaginal biopsies for an abnormal Pap test, 15(28{\%}) were normal, 23(43{\%}) were VAIN1, 9(16{\%}) were VAIN2, and 7(13{\%}) were VAIN3. No patients had invasive vaginal cancer.CONCLUSION: Over 30{\%} of HIV-infected women who had no pre-hysterectomy history of an abnormal Pap test had abnormal vaginal Pap tests. Among those who had vaginal biopsies, 29{\%} had VAIN2 or VAIN3, suggesting that Pap tests post-hysterectomy in the HIV population may be indicated.",
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