The impact of the COVID-19 pandemic on cervical screening and outcomes for women living with HIV
HIV Medicine
; 24(Supplement 3):64, 2023.
Article
in English
| EMBASE | ID: covidwho-2325845
ABSTRACT
Background:
Current published Faculty of Sexual and Reproductive Health (FSRH) guidelines recommend annual cervical screening for women living with HIV(WLHIV) but do not reflect current evidence. Aim(s) 1. To assess the impact of the Covid-19 pandemic on frequency and interval of cervical screening in WLHIV 2. To report any changes in outcomes of cervical screening in WLHIV during Covid-19Method:
Data were collected retrospectively over 3 years defined as Pre-Covid (23/3/2019-22/3/2020), during Covid lockdowns (23/3/2020-22/3/2021) and Post-Covid lockdowns (23/3/2021-22/3/2022). Data was collated on demographics, HIV-related data, previous abnormal cervical screens/colposcopy, smoking and high-risk Human Papilloma Virus(hrHPV) vaccination. Result(s) Data was available for 70 women. Mean age was 48 years, 44.3%(n=31) were of African ethnicity. Mean duration of HIV diagnosis was 19 years. 22.9% (n=16) had a previous ADI, median CD4 was 768(range 35-1891), median nadir-CD4 439(range 3-1472), 94.3% (n=66) were taking ARVs and 87.1%(n=61) had HIV-VL <40 copies/ml. 42.9%(n=30) had a previous abnormal cervical screen and 78.6%(n=55) had undergone colposcopy. 4.3%(n=3) were vaccinated against hrHPV. 18.6% (n=13) currently smoked. 60%(n=42) women underwent cervical screening Pre- Covid, 41.4%(n=29) during and 78.6%(n=55) Post-Covid. 19.6-37.2% fewer women were screened during Covid compared to Pre and Post-Covid. 9.5%(n=4) women screened Pre-Covid tested positive for hrHPV compared with 6.9%(n=2) during Covid and 12.7%(n=7) Post-Covid. No cytology changes were seen for the majority however cervical intraepithelial neoplasia(CIN) grade 1 was detected in 2.4%(n=1) Pre- Covid, compared with 3.4%(n=1) during covid and 5.4% (n=3) Post-covid. Post-Covid 1.82%(n=1) had CIN grade 2 detected, no women pre or during covid had CIN grade 2 detected. No women Pre, during or Post-covid had CIN grade 3 or cervical neoplasm detected on cytology. Conclusion(s) Covid increased cervical screening intervals for WLHIV but did not result in delayed cervical cancer diagnosis. FSRH guidelines are currently under review regarding screening intervals. This data, although small in number, may support European AIDS Clinical Society and Department of Health and Human Services guidelines which have extended screening intervals for PWLH especially for those who tested negative for hrHPV.
acquired immune deficiency syndrome; adult; cancer diagnosis; colposcopy; conference abstract; coronavirus disease 2019; cytology; demographics; ethnicity; female; human; Human immunodeficiency virus infected patient; human tissue; major clinical study; male; middle aged; nonhuman; pandemic; practice guideline; reproductive health; retrospective study; smoking; uterine cervix cancer; uterine cervix carcinoma in situ; Wart virus; CD4 antigen; endogenous compound; virus vaccine
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Diagnostic study
/
Experimental Studies
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Language:
English
Journal:
HIV Medicine
Year:
2023
Document Type:
Article
Similar
MEDLINE
...
LILACS
LIS