Abnormal Pap test results were observed in more than 30% of HIV-infected women who had no prehysterectomy history of abnormal Pap test results, according to a recent cohort study of 238 women between January 2000 and January 2015 with a history of HIV, previous hysterectomy, and no previous abnormal Pap test results. Researchers found:
• 164 (69%) women had normal Pap test results, 12 (5%) had results showing atypical cells of undermined significance and HPV, 55 (23.1%) had results showing low-grade squamous intraepithelial lesion, and 7 (2.9%) had results showing high-grade squamous intraepithelial lesion.
• Median follow-up for the Pap test was 16 years.
• Of those who underwent vaginal biopsies for abnormal Pap test results, 15 (28%) had normal results, 23 (43%) had vaginal intraepithelial neoplasia (VAIN)-1, 9 (16%), had VAIN 2, and 7 (13%) had VAIN 3.
• No patients had invasive vaginal cancer.
The authors concluded that Pap testing posthysterectomy in the HIV population may be indicated.
Citation: Smeltzer S, Yu X, Schmeler K, Levison J. Abnormal vaginal Pap test results after hysterectomy in human immunodeficiency virus-infected women. [Published online ahead of print June 6, 2016]. Obstet Gynecol. doi:10.1097/AOG.0000000000001457.