Prevalence and predictors of abnormal Papanicolaou smears in HIV-infected women.

PURPOSE OF INVESTIGATION: To characterize the risk factors for abnormal cervical cytology among women with human immunodeticiency virus (HIV), and to determine the relationship between antiretroviral therapy (ART) and cytology results. MATERIALS AND METHODS: Retrospective study of clinical data of 115 HIV-infected women between January 2008 and December 2011. Analysis of cervical smears history, as well as, epidemiologic, medical, and sexual factors, administration of ART, CD4 cells count, and HIV viral load were performed. RESULTS: Mean age was 35.9 ± 6.5 years. Average time of HIV infection was 10.5 ± 4.5 years. HPV infection prevalence was 37.4%, the majority was high-risk. An abnormal Papanicolaou smear was found in 43.5%. Atypical squamous cell of undetermined significance (ASC-US) was reported in 7.8%, low-grade squamous intraepithelial lesions (LSIL) in 32.2%, and high-grade squamous intraepithelial lesions (HSIL) in 3.5%. HPV infection was the only statistical predictor of abnormal cytology (p < 0.001; OR = 0.042). ART, CD4 cells count, and HIV viral load did not correlate to regression of abnormal cytology. CONCLUSION: These women should be followed-up according to current cervical cancer screening guidelines, independently of the therapy, CD4 cells count, and HIV viral load.

[Comparative study of benign and malignant tumor of the ovary]. / Estudo comparativo de tumores benignos e malignos do ovário.

This study concerns the evaluation of epidemiologic, clinical and laboratory parameters and the comparison of the multiple parameters between benign and malignant tumors of the ovary to establish significant criteria allowing a Malignant Risk Index to be defined. The incidence of ovarian cancer was higher among post-menopausal women with no use of oral contraceptives. There was no correlation between sterility, infertility or nulliparity and ovarian cancer. The age at menarche, menopause or first term delivery showed no influence on the risk of ovarian cancer. The Authors verified significant differences (p < 0.001) in the levels of serum CA 125 between patients with benign ovarian tumors and patients with ovarian cancer. Those differences showed high sensitivity and specificity. Ultrasonographic criteria were difficult to interpret because of their subjectivity. However, there were significant differences concerning the size of the tumors, the bilaterality, the solid component and ascites; all these criteria were more frequent among malignant masses. It is imperative to define a high confidence degree Malignant Risk Index for ovarian tumors allowing the establishment of screening strategies applicable to risk populations.