Year: 2024 | Month: February | Volume: 14 | Issue: 2 | Pages: 262-270
DOI: https://doi.org/10.52403/ijhsr.20240235
Cytological Aspects of Cervico-Uterine Smears from HIV/HPV HR Coinfected Women Treated with Antiretrovirals
Maryse N Akolbout Manguilla1,2, Fabien Mouamba1,3, Dimitry Moudiongui3, Norcely Makela2, Jethro Massala4, Dieudonné Kaboré3, Rocide Moukouba2, Christ Arcel Massamba Ndala2, Edith, Sophie Kombo Bayonne1, Jean Félix Peko1,3
1Faculty of Health Sciences, Marien Ngouabi University, Congo
2Outpatient Treatment Center; Brazzaville, Congo
3Service at the Pathological Anatomy Laboratory of the University Hospital of Brazzaville
4Direction of epidemiology and disease control, Brazzaville, Congo
Corresponding Author: Maryse N Akolbout Manguilla
ABSTRACT
Introduction: Women living with HIV are at high risk of developing persistent HPV-HR infections. This favors the development of precancerous lesions that may progress to cervical cancer. With a view to improving management and taking preventive action against cervical lesions and cervical cancer in women living with HIV, our study aimed to describe cervical abnormalities and establish a relationship between lesion severity and HPV-HR genotypes in HIV/HPV-HR co-infected women.
Methodology: This was a descriptive cross-sectional study conducted at the CTAB from March 2021-December 2022. Of 122 women living with HIV screened HPV HR positive 90 presented for FCU. Cervico-uterine smears were read after Papanicolaou staining by two cytopathologists at the anatomy-cytology-pathology laboratory of the university hospital center. Results were rendered according to the 2014 Bethesda system classification, and data processing was performed using SPSS 25 software.
Results: 90 patients co-infected with HIV/HPV-HR were included, with a mean age of 44.16±10.08 years, ranging from 20 to 70 years. The women in our study were all on triple therapy, and most had a controlled viral load and CD4 count above 200mm3. Cytological abnormalities accounted for 38.9%, with a predominance of atypical squamous cells of undetermined significance (ASCUS) 51.43%, followed by low-grade squamous intraepithelial lesions (LSIL) 37.14% and 11.43% of atypical squamous cells for which a high-grade lesion could not be excluded (ASC-H). Triple therapy had a protective impact in women against progression to precancerous states, although no statistically significant association was observed between cervical lesions and HR-HPV genotypes (p=0.819).
Conclusion: Our study reveals a high proportion of ASCUS lesions in women living with HIV and co-infected with HPV HR. Triple therapy has a protective effect against progression to severe lesions. To this end, screening for precancerous lesions in this population should include diagnosis of the P16 protein by Histoimmuno chemistry.
Key words: FCU, HR- HPV, Women, HIV, ARV, Congo.