Frequency of human papillumavirus among women with high-grade squamous intraepithelial lesions and invasive cervical cancer attending Shahid Beheshti University of Medical Sciences Clinics, Tehran, Iran

The previous studies reported some information about prevalence release of high-risk HPV types in HSIL or cervical cancer globally and in Iran, however, this information is not enough for final judgment about vaccination against HPV or any screening program. The aim of the present study was to assess the HPV type distribution in HSIL and ICC specimens of women attending Shahid Beheshti University of Medical Sciences teaching hospitals, Tehran, Iran for treatment during 10 years. This retrospective- descriptive study evaluated the HPV type distribution of pathologic specimens of Iranian women with invasive cervical cancer [ICC] and high-grade squamous cell intraepithelial lesions [HSIL]. Formalinfixed tumor biopsies that were retrieved from women presenting with histological confirmation for ICC and 17 pathologic confirmation for HSIL specimens. The most frequently identified HPV type 16 among both groups, women with invasive cervical cancer [42.18%] and women with High Grade Squamous Intraepithelial Lesion [29.41%], followed by HPV18, HPV31 and 26. HPV16 and / or 18 accounted for 82.2% of all infected samples. The dominance of HPV16 over other high-risk types might be even higher than in a region with low HPV exposure. However, there was no strong evidence for any judgment that show to the policy makers; which one is cost-effectiveness and feasibility for cervical cancer prevention in Iran, vaccination, screening or both? More population based study and national meta-analysis needed for better understanding of HPV prevalence and HPV DNA patterns in Iran

pathogenic microorganisms in papanicolaou vaginal smears and correlation with inflammation

Non-specific cervicitis or inflammatory changes in a smear report are common which are usually unclear for clinical approaches. To investigate the frequency of inflammation and pathogenic vaginal microorganisms in cervical smears among an Iranian population sample. This cross-sectional study was carried out on Pap smear samples of women referred to gynecological clinic of Taleghani Hospital in Tehran, Iran, between October 2008 and March 2009. This study was conducted on 528 conventional Papanicolaou cervical smears. The frequency and severity of inflammation and prevalence of bacterial vaginosis [BV], Trichomonas vaginalis [TV], and vaginal candidiasis [VC] was determined in the samples. Also co-infection of the microorganisms in Pap samples was evaluated. percentage, mean +/- standard deviation of the outcome parameters were calculated. The comparison between data was performed with the Pearson's chi square or Fisher's exact test. The prevalence of BV, VC, and TV in Pap samples was 17%, 11%, and 0.4% respectively. Overall, the prevalence of these microorganisms in women of reproductive age was higher than menopausal women. There was a significant association between VC and the presence of inflammation in our samples. Based on our results, inflammation in the Pap smears can suggest an infection of VC and the patients should be considered for proper VC treatment

[Cervical smear in HIV infection]

Today with an increasing frequency of HIV infection around the world, its epidemiological studies is becoming more important. This study aimed to evaluate the cervical smear in human immunodeficiency virus [HIV] infected patients and also its association with CD4 counts among an Iranian population. In a case-control study, 247 women, 58 HIV infected cases and 189 healthy controls, were included. Liquid-based cytology cervical smears and hematologic findings were compared between cases and controls. The frequency of abnormal smear was significantly higher in cases 20.7% compared with controls 3.2% [p<0.001]. The mean CD4 count was significantly lower in cases with abnormal smear compared with cases with normal smear [573.0 +/- 306.9 vs. 383.7 +/- 123.6; p=0.042]. Undertaking a serious effort toward provision of gynecological care and cervical cancer screening at the same health center as HIV care, in Iranian HIV infected women is suggested

Knowledge and Attitude of Women Regarding the Human Papillomavirus (HPV) Infection, Its Relationship to Cervical Cancer and Prevention Methods

This study aimed to determine knowledge and attitude of women to HPV and its association with cervical cancer and prevention methods. In a cross-sectional study, 500 women, aged between 20 and 50 presenting to local health centers in Tehran, were asked about demographic factors and questioned about cervical cancer, HPV, and prevention methods. Responses were tabulated and summarized. Although knowledge of HPV, its relation to cervical cancer and prevention methods among Iranian women is not enough, their attitude towards education in this regards is extremely high. The results reflect the need of advertising and educational programs for public about HPV prevention methods, to reduce the prevalence of this infection and its severe consequences.

[ value of Pap smear in detecting cervical neoplasia compared with histopathologic findings in patients referred to Taleghani Hospital, Tehran 2007-2009]

Although the Pap smear screening test has showed a great success in early diagnosis of cervical cancer in different countries over the past 60 years, cervical cancer has remained the fifth most common cancer among Iranian women. The diagnostic value of Pap smears which are done in health centers around the country compared with international standards for cervical cancer screening requires further consideration. The purpose of this study was to compare Pap test's findings with colposcopic biopsies as the gold standard. In this cross-sectional study, all non-pregnant women attended to Taleghani hospital gynecology clinic between 2007 and 2009 for routine Pap smear and were volunteer to participate in this research, and based on clinical findings as well as colposcopist's opinion had an indication for colposcopy, were included. Eligible women had a Pap test as well as colposcopy and cervical biopsy thereafter. Sensitivity, specificity, positive and negative predictive value [PPV and NPV] of Pap test was calculated compared with cervical biopsy as the gold standard. Overall,%67 of women had abnormal biopsy [mostly HPV appearance], whereas only%21 of Pap smear results indicated abnormal cervical screening test results. The sensitivity, specificity, PPV, and NPV of Pap smear for detecting cervical neoplasia in our study was%23.9,%84.8,%76.2, and%35.4, respectively. The sensitivity of Pap smear was less than other reports. It needs more quality control, including sampling, sample preparation and interpretation in this center. Studies with more samples in other hospitals and particularly in different health care centers in Iran are highly recommended

Squamous intraepithelial lesions associated with HIV infection and CD4+ cell counts in an Iranian population

To evaluate the association between cervical squamous intraepithelial lesions [SIL] and the human immunodeficiency virus [HIV] infection and CD4 counts among an Iranian population. Case-control study. North and East Tehran Health Centers, related to Shaheed Beheshti Medical University, Iran. Two hundred forty seven women including 58 HIV infected cases and 189 healthy controls recruited between 2007 and 2010. None. Cytology-based cervical Pap smears and hematologic findings were compared between cases and controls. The prevalence of abnormal smear was significantly higher in the study group [36.2%, 15 LSIL + 6 HSIL] compared with controls [3.2%, 6 ASCUS] [p < 0.001, OR = 2.4, 95% CI 1.2 - 4.6]. The mean of CD4 count was significantly lower in cases with abnormal smear compared with cases with normal smear [573.0 +/- 306.9 Vs 383.7 +/- 123.6; p = 0.042]. Our results suggest the need for undertaking a serious effort towards the provision of gynecological care and cervical cancer screening at the same health center as HIV care, in Iranian HIV infected women