SQUAMOUS INTRAEPITHELIAL CERVICAL LESIONS IN HUMAN IMMUNODEFICIENCY VIRUS-SEROPOSITIVE WOMEN

OBJECTIVE: To evaluate the relationship between human immunodeficiency virus (HIV) infection, CD4 serum level, cervical squamous intraepithe lial lesions (SILs) and risk factors for human papillomavirus (HPV)-re lated dysplasia in HIV-positive women. STUDY DESIGN: All 51 eligible p atients who were seen at the Colposcopic Out-patient Service, Aviano C ancer Center, Aviano, Italy, from July 1, 1993, to June 30, 1994, were studied for risk factors for HPV and HIV infection and had cervical c ytologic smears, coloscopy with cervical biopsy and serum CD4 count. R ESULTS: Thirty of 51 patients (59%) had cytohisto-logically confirmed SIL. The prevalence of SIL was higher in HIV Centers for Disease Contr ol stage IV disease than stages II and III (22/29 vs. 8/22 P < .05). T here was no significant difference in the CD4 count between women with or without SIL (321 +/- 310 vs. 401 +/- 295/mm3 [mean +/- SD]). No re lationship wa found between CD4 count and severity of SIL (low grade S IL, 210 +/- 203/mm(3); high grade SIL, 580 +/- 357/mm(3)). CONCLUSION: In our series there was no relationship between CD4 count and cervica l SIL, suggesting that the expression of HPV-related dysplasia is a co mplex process in which risk factors for genital SIL play and important role, while the role of HIV must be defined again.