American Journal of Obstetrics & Gynecology
Volume 203, Issue 1 , Pages 21.e1-21.e6, July 2010

Abnormal anal cytology in HIV-infected women

Presented at the 45th Annual Meeting of the Infectious Diseases Society of America, San Diego, CA, Oct. 4-7, 2007; the International Papillomavirus Conference and Clinical Workshop, Beijing, China, Nov. 3-10, 2007; the Biennial Meeting of the American Society for Colposcopy and Cervical Pathology, Orlando, FL, March 17-20, 2008; and the 56th Annual Clinical Meeting of the American College of Obstetricians and Gynecologists, New Orleans, LA, May 3-7, 2008.

  • Richa Tandon, MD

      Affiliations

    • Division of Internal Medicine, Section of Infectious Diseases, Boston University Medical Center, Boston, MA
    • ,
  • Amy S. Baranoski, MD

      Affiliations

    • Division of Internal Medicine, Section of Infectious Diseases, Boston University Medical Center, Boston, MA
    • Corresponding Author InformationReprints: Amy S. Baranoski, MD, 850 Harrison Ave., Dowling 3 North, Boston, MA 02118
    • ,
  • Faye Huang, NP

      Affiliations

    • Division of Internal Medicine, Section of Infectious Diseases, Boston University Medical Center, Boston, MA
    • ,
  • Antonio de las Morenas, MD

      Affiliations

    • Department of Pathology, Boston University Medical Center, Boston, MA
    • ,
  • Olivera Vragovic, MBA

      Affiliations

    • Division of Obstetrics and Gynecology, Boston University Medical Center, Boston, MA
    • ,
  • Meg Sullivan, MD

      Affiliations

    • Division of Internal Medicine, Section of Infectious Diseases, Boston University Medical Center, Boston, MA
    • ,
  • Elizabeth A. Stier, MD

      Affiliations

    • Division of Obstetrics and Gynecology, Boston University Medical Center, Boston, MA

Received 14 August 2009; received in revised form 21 October 2009; accepted 12 January 2010. published online 11 March 2010.

Objective

The purpose of this study was to assess the prevalence of and risk factors for abnormal anal cytology and human papillomavirus (HPV) infections in women who are human immunodeficiency virus (HIV) positive.

Study Design

We conducted an observational single center study of 100 HIV-infected women with cervical and anal specimens that were obtained for cytologic and high-risk HPV testing with Hybrid Capture 2.

Results

Seventeen women had abnormal anal cytology; 16 women had anal HPV; 21 women had abnormal cervical cytology, and 24 women had cervical HPV. Abnormal anal cytology was associated with cervical HPV infection, abnormal cervical cytology, and anal HPV infection in univariate analysis. In multivariate analysis, abnormal anal cytology was associated with a CD4 count <200 cells/mm3, a history of sexually transmitted disease, and concurrent cervical cytologic abnormality.

Conclusion

HIV-infected women are at high risk for abnormal cytology and HPV infections of both the anus and cervix. Risk factors for abnormal anal cytology include abnormal cervical cytology, cervical and anal HPV infections, and low CD4 count.

Key words: anal cytology, anal HPV, cervical cytology, cervical HPV, HIV

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 Supported by departmental funds and National Institutes of Health Grant 5 T32 AI52074-05.

 Cite this article as: Tandon R, Baranoski AS, Huang F, et al. Abnormal anal cytology in HIV-infected women. Am J Obstet Gynecol 2010;203:21.e1-6.

PII: S0002-9378(10)00021-9

doi:10.1016/j.ajog.2010.01.010

American Journal of Obstetrics & Gynecology
Volume 203, Issue 1 , Pages 21.e1-21.e6, July 2010

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