TITLE:
HIV+ Status and Cervical Cancer: Cytological Aspects of Cervical Smear in Cameroon Setting
AUTHORS:
Essome Henri, Engbang Jean Paul, Ekono Michel Roger, Nana Njamen Theophile, Mve Koh Valere, Boten Merlin, Tocki Toutou Grâce, Fewou Amadou
KEYWORDS:
HIV, HPV, Dysplasia, Cervical Cancer
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.10 No.1,
January
8,
2020
ABSTRACT: Introduction: The early detection of precancerous lesions being
very important for the preventive
management of cervical cancer, we felt it was important to identify
these lesions on potential backgrounds including HIV-positive
(HIV+) women to suggest control strategies of cervical cancer in Cameroon. Objective: To determine the prevalence of precancerous lesions in women infected with the
human immunodeficiency virus (HIV), to investigate the determinants of the HIV and cervical cancer association, and to make
recommendations regarding cervical cancer screening in these patients of
the city of Douala. Methodology: Our study was a case-control cross-sectional study
from July 2017 to December 2017 (6 months) including
108 women among which 34 HIV+ matched with 74 HIV-. HIV serology was done using the complete
HIV enzygnost test. Cervical smears for cytological lesions were fixed to the
cyto-fixator and then stained by the Papanicolaou technique and read under an
optical microscope. The cervical smear slides for viral excretion were fixed
with a methanol-acetone mixture of equal volume; HPV testing was done by the
indirect immune-peroxidase technique using P16 protein. The excretion of HSV
type 1 & 2 was investigated by the indirect immunofluorescence technique
using the Simplex Virus type 1 & 2 Rabbit anti-Herpes from DAKO (France). Results: The two groups of women were compared with the chi square test with a
significance threshold of P 0.05.
The average age was 40.07 with extremes of 21 and 71 years and a standard
deviation of 9.99. Of the 34 HIV+ patients, 23 had an abnormal cervix compared
to 36 cases of abnormal cervix among HIV- with a statistically significant difference
(P = 0.006649). 12 cases of dysplasia were observed in the 34 HIV+ women and
distributed as follows: 0% of mild dysplasia, 18.92% of moderate dysplasia and
13.51% of severe dysplasia. In HIV- women we detected 6 cases of dysplasia including 1.35% of mild
dysplasia, 4.05% of moderate dysplasia and 2.70% of severe dysplasia. Regarding
HPV infection, we observed 21 cases of HPV among 34 HIV+ women (61.76%) against
23 cases in HIV-lesions remains high in HIV+ women, hence
the need to include routine screening for precancerous lesions in all HIV+
women at all ages, as well as the routine search for HPV excretion in all those
with cellular dysplasia.