CHARACTERISTICS OF CERVICAL INTRAEPITHELIAL NEOPLASIA IN WOMEN INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

OBJECTIVE: Our purpose was to compare characteristics of cervical intr aepithelial neoplasia in relation to human immunodeficiency virus infe ction among women referred to a public hospital colposcopy clinic with Papanicolaou smears showing cervical intraepithelial neoplasia. STUDY DESIGN: An evaluation of cervical intraepithelial neoplasia severity, lesion size, and vulvovaginal lesions with respect to human immunodef iciency virus status was performed. RESULTS: (1) Human immunodeficienc y virus prevalence in 482 women with cytologic characteristics of cerv ical intraepithelial neoplasia was 13%. (2) In human immunodeficiency virus-infected patients, Papanicolaou smears were less adequate for ev aluation and correlated less well with histologic findings than in uni nfected patients (p < 0.05). (3) Human immunodeficiency virus-infected patients (n = 47) had more advanced cervical intraepithelial neoplasi a, larger cervical lesions, and more associated vulvovaginal lesions t han human immunodeficiency virus-negative patients (n = 161). In human immunodeficiency virus-positive women, the severity of cervical intra epithelial neoplasia was not associated with age, whereas in human imm unodeficiency virus-negative women, increasing severity was significan tly associated with increasing age. CONCLUSION: High rates of human im munodeficiency virus infection in inner-city colposcopy services and h igh-grade, extensive cervical lesions in infected women warrant specia l attention.