Low grade squamous intraepithelia lesions in HIV-infected women at Chris Hani Baragwanath academic hospital

A Dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfillment of the requirements for the degree of Master of Medicine in the branch of Obstetrics and Gynaecology. Johannesburg, 2016Background: HIV positive women have a greater risk of cancer of the cervix and they were also found to have high rates of prevalent and incident LSIL and HSIL. Both HIV and Cervical cancer are major public health problems in South Africa. This study will therefore assess whether HIV infected women with a LSIL on Pap smear have clinically significant cervical disease as determined by histology. Methods: HIV positive women with cytological abnormality on Pap smear are referred to colposcopy according to the SA guidelines. When the colposcopy is more than CIN2 a LLETZ is performed. Data was extracted from a colposcopy database. Results: There were 652 patients and the mean age was 36.55 years and the median parity was 3.00. There were 266 women (40.80%) who had a histology result of HPV/CIN 1 and 386 women (59.20%) who had a histology result of CIN 2 or more severe lesion. Conclusion: Our study showed that most of the patients that were referred to our colposcopy clinic had CIN2 or more severe on histology and there were 5 women with invasive disease. The time from performing the Pap smear to colposcopy is extremely long. It is important that women with LSIL be referred to colposcopy as soon as possible.MT201