Abnormal cervical cytology amongst women infected with human immunodeficiency virus in Limpopo province, South Africa

Abstract

Background: Cervical cancer remains the major public problem worldwide and the most common gynaecological malignancy in the developing world, particularly in sub-Saharan Africa.Aim: To determine the prevalence of abnormal cervical cytology amongst women with and without human immunodeficiency virus (HIV) and examine the association between HIV and histological grading.Setting: The study was conducted in Limpopo province, which is the northernmost province of South Africa. The province has five district municipalities with one tertiary, five regional and thirty four district hospitals.Methods: We retrospectively reviewed cervical cancer cases in Limpopo province (LP) of South Africa, using data collected routinely by the National Health Laboratory Services (NHLS). The data on smears submitted for cytology between 2013 and 2015 were extracted from the Central Data Warehouse (CDW) database.Results: A total of 84 466 women were screened for cervical cytology smears. Their mean age was 39.8 ± 13.6 years, with range from 15 to 113 years; 77.2% were in the age group 30 years and older and 19.6% had an abnormal cervical cytology result. Overall, 46.4% of the women screened for cervical cancer were HIV infected. A significantly higher proportion of HIV-positive women had abnormal cytology than HIV-negative women (31.8% vs. 9.2%).Conclusion: The prevalence of abnormal cytology amongst HIV-positive women is relatively high, and the risk appears to be significantly greater in all age groups. This finding highlights the need to ascertain HIV status of all women presenting with cervical cancer.

Cervical Microbiota Influences Cytokine Diversity in Cervical Intraepithelial Neoplasia among Rural Women in the Akyemansa District of Ghana

“…In China, CIN 1 and CIN 2 pooled prevalence of 3.4% and 1.5% has been reported [ 42 ]. Contrary to our study, Ntuli et al [ 43 ] reported a higher proportion (19.2%) of abnormal cytology among participants in South Africa. This finding reflects differences in geographical location and lifestyle among the participants.…”

Cervical cancer screening in women living with HIV attending primary care clinics in a health district, South Africa: a descriptive cross-sectional study

“…The suboptimal uptake of cervical cancer screening identified in this study is a concern, especially for women living with HIV and considered at high risk of developing cervical cancer. This study reports an uptake that is lower than 46.4% and 65.4% in research conducted in Limpopo and Soweto, respectively [ 8 , 9 ]. Surprisingly, more women living with HIV in Limpopo Province, rural South Africa, were screened than women in this study, yet the latter was an urban area and part of the economic hub of South Africa.…”

“…For women living with HIV, the South African policy on cervical cancer recommends screening be done at three-year intervals starting as soon as HIV is diagnosed [ 6 ]. South African data showed that women living with HIV had a higher prevalence of HPV infection than women who were HIV-negative because of sexual behavior and immune suppression due to HIV infection [ 7 , 8 ]. Evidence reveals that the incidence and progression of the squamous intraepithelial lesion (SIL) and cervical cancer could be reduced by early ART initiation and adherence [ 9 - 13 ].…”