Associated risk factors of human papillomavirus cervical infection among human immunodificiency virus-seropositive women at Siriraj Hospital.

This cross sectional type sub-study was established to assess the potential risk factor associated with human papillomavirus (HPV) cervical infection in Human immunodeficiency virus (HIV)-seropositive women. The series of 178 HIV-seropositive women was enrolled in the Department of Obstetrics & Gynecology, Siriraj Hospital. Demographic, obstetrical and behavioral risk factors were interviewed. Laboratory results were recorded. Clinical gynecologic examination was performed including Pap smear. The patients were assigned into two groups, HPV and non-HPV group. The comparison of the potential risk factors between the groups was calculated statistically. It was found that the prevalence of HPV infection was reported in 17 patients (9.6%). HIV-seropositive women, who were infected with HPV, had a significantly more probability to have a single partner in their lifetime than those who were not infected. It could be that HPV cervical infection and HIV-seropositive women share common potential risk factors, as well as, the recognition of sexual intercourse as the important route of HPV transmission.

Rapid human immunodeficiency virus diagnostic test during the intrapartum period in pregnant women who did not receive antenatal care.

The main barrier to implementation of antiretroviral drugs in HIV-infected pregnant women is the lack of antenatal care (ANC). From April 1999 to December 2001, the prevalence of pregnant women not receiving ANC and coming for delivery in Siriraj Hospital was 7.3 per cent (2,152/29,484) and the prevalence of HIV infection among this group was 5.7 per cent, substantially higher than that of 27,332 pregnant women receiving ANC in Siriraj Hospital (2.2%). Besides developing interventions to increase use of ANC, the test for diagnosis of HIV infection during the intrapartum period should be rapid, inexpensive, highly sensitive and specific, easy to perform and results should be easy to interpret. The Determine Rapid Test for detection of HIV fulfills these criteria with 100 per cent sensitivity, 99.85 per cent specificity, 97.54 per cent positive predictive value, 100 per cent negative predictive value and 0.14 per cent false positive. To improve prevention of mother-to-child HIV transmission (PMTCT), the authors believe that this uncomplicated rapid HIV testing should be used during the intrapartum period to Thai-pregnant women who did not receive antenatal care and antiretroviral drugs might be offered as soon as possible for those testing HIV-positive and for their baby as chemoprophylaxis.