Short-term follow up of cervical squamous intraepithelial lesions associated with HIV and human papillomavirus infections in Africa

A prospective study in gynaecology clinics was conducted in Abidjan, Cote d 'Ivoire, to assess the short-term evolution of squamous intraepithelial les ions (SILs). Of 94 women with a cytological diagnosis of SIL, 38 were infec ted with HIV. The average follow-up period after the initial smear was 5 mo nths. Detection of human papillomavirus (HPV) by polymerase chain reaction (PCR) was performed at both the time of enrolment and final follow-up smear . There were 39 cases of persistent Sns. HIV-positive women had a higher pe rcentage of persistent Sa (76%) than HIV-negative women (18%, relative risk (RR)=4.3, 95% confidence interval (CI)=2.4, 7.7). SILs were more frequent among women infected with HPV at the time of enrolment or with persistent H PV infection, but these associations disappeared after adjusting for HIV se rostatus. Spontaneous regression of SILs commonly occurs in HIV-negative Af rican women. HIV-infected women with cervical dyskaryosis require gynaecolo gy follow-up.