Association between CD4+ T-cell count, atypical squamous cells and Schiller’s test in women with HIV/AIDS

Abstract

Objective: Infection with HIV increased risk for the development of cancer, such as Kaposi’s sarcoma and invasive cancer of the cervix. Given the importance of health promotion in women, the purpose of this study was to perform cytological screening (Pap smear) and identify any association between CD4+ T-cell, atypical squamous cells and the Schiller’s Test in women with HIV/AIDS in Brazil.

Design: Descriptive and cross-sectional study.

Setting: Gynaecology outpatient clinic in Fortaleza, Ceará, Brazil.

Subjects: A total of 76 women with HIV/AIDS were examined and included in the study.

Main outcome measures: For data collection a questionnaire to gather sociodemographic, clinical, epidemiological and  gynaecological data and the association between CD4+ T-cell count, atypical squamous cells and Schiller’s test in women with HIV/AIDS were performed.

Results: Seventy-six women were evaluated, among which 43.5% had a positive Schiller’s test and 94.8% manifested some type of inflammatory process. There was statistical significance between atypical squamous cells and the number of partners (P=0.021), age of first sexual intercourse (P=0.003) and positive Schiller’s test (P=0.008). Of the patients with atypical squamous cells, eight had a low-grade, intraepithelial lesion, comprising the cytopathic effect of HPV and cervical intraepithelial neoplasia grade I (CIN I); three had intraepithelial lesion high-grade (CIN comprising II and III). There was a relationship between CD4+ T-cell counts and atypical squamous cells (P=0.028) and a positive Schiller’s test (P=0.030).

Conclusion: Increased vulnerability occurred to cervix changes with a reduction in the CD4+ T-cell counts.