Association of vitamin A deficiency with cervical squamous intraepitheliallesions in human immunodeficiency virus-infected women

To explore the relationship between vitamin A (retinol) deficiency and cerv ical squamous intraepithelial lesions (SILs) in human immunodeficiency viru s (HIV)-infected women, we measured serum retinol concentrations in 1314 wo men enrolled in the Women's Interagency HIV Study and correlated the result s with concurrent cervical cytology, At the baseline visit, 204 (15.5%) of the 1314 patients had retinol concentrations consistent with deficiency (<1 .05 mu mol/L). Analysis of Papanicolaou smears showed SILs in 216 (16.4%) o f 1314 women. Cervical SILs were found to be associated with retinol concen trations <1.05 mu mol/L (multivariate odds ratio [OR], 1.63; P = .04) in a multivariate model, which included human papillomavirus (HPV) status and ma rkers of nutritional status and HIV disease stage. In the subset of women w ith genital HPV (n = 774), a multivariate analysis again revealed a signifi cant independent association between retinol <1.05 mu mol/L and cervical SI Ls (multivariate OR, 1.75; P = .02). Our findings suggest that retinol defi ciency may contribute to the development of cervical SILs in HIV-infected w omen.