Abnormal vaginal pap test results after hysterectomy in human immunodeficiency virus-infected women

Stephanie Smeltzer, Xiaoying Yu, Kathleen Schmeler, Judy Levison

Research output: Contribution to journalArticle

3 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 and January 2015 with a history of HIV, previous hysterectomy, and no previous abnormal Pap test results. Medical records from patients with both HIV and a 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 seven (2.9%) had results showing high-grade squamous intraepithelial lesion. No demographic risk factor was associated with abnormal Pap test results after hysterectomy. Median follow-up time for the Pap test was 16 years. Of those who underwent vaginal biopsies for abnormal Pap test results, 15 (28%) had normal results, 23 (43%) had VAIN 1, nine (16%) had VAIN 2, and seven (13%) had VAIN 3. No patients had invasive vaginal cancer. CONCLUSION: More than 30% of HIV-infected women who had no prehysterectomy history of abnormal Pap test results had abnormal vaginal Pap test results. Among those who had vaginal biopsies, 29% had VAIN 2 or 3, suggesting that Pap testing posthysterectomy in the HIV population may be indicated.

Original languageEnglish (US)
Pages (from-to)52-57
Number of pages6
JournalObstetrics and Gynecology
Volume128
Issue number1
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Abnormal vaginal pap test results after hysterectomy in human immunodeficiency virus-infected women. / Smeltzer, Stephanie; Yu, Xiaoying; Schmeler, Kathleen; Levison, Judy.

In: Obstetrics and Gynecology, Vol. 128, No. 1, 01.07.2016, p. 52-57.

Research output: Contribution to journalArticle

Smeltzer, Stephanie ; Yu, Xiaoying ; Schmeler, Kathleen ; Levison, Judy. / Abnormal vaginal pap test results after hysterectomy in human immunodeficiency virus-infected women. In: Obstetrics and Gynecology. 2016 ; Vol. 128, No. 1. pp. 52-57.
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