Abnormal pap posthysterectomy for 30 percent of HIV+ women

(HealthDay)—About one-in-three HIV-infected women with no prehysterectomy history of abnormal Pap results have abnormal vaginal Pap results after hysterectomy, according to a study published in the July issue of Obstetrics & Gynecology.

Stephanie Smeltzer, M.D., from the Baylor College of Medicine in Houston, and colleagues reviewed the medical records of 238 women with a history of HIV, previous hysterectomy, and no previous abnormal Pap test results.

The researchers found that 69 percent of women had normal Pap test results and 5 percent had results showing atypical cells of undetermined significance and human papillomavirus-positive; 23.1 and 2.9 percent had results showing low- and high-grade squamous intraepithelial lesions, respectively. There was no correlation for demographic factors with abnormal Pap test results after hysterectomy. Among women who underwent vaginal biopsies for abnormal Pap test results, 28, 43, 16, and 13 percent, had normal results, vaginal intraepithelial neoplasia (VAIN) 1, VAIN 2, and VAIN 3, respectively. None of the patients had invasive vaginal cancer.

"More than 30 percent of HIV-infected women who had no prehysterectomy history of abnormal Pap test results had abnormal vaginal Pap test results," the authors write. "Among those who had vaginal biopsies, 29 percent had VAIN 2 or 3, suggesting that Pap testing posthysterectomy in the HIV population may be indicated."