Relação entre diagnóstico citopatológico de neoplasia intra-epitelial cervical e índices de células CD4+ e de carga viral em pacientes HIV-soropositivas

• Autor(a) principal: Coelho, Raquel Autran [UNIFESP]
• Data de Publicação: 2004
• Outros Autores: Facundo, [UNIFESP], Nogueira, Aline Leite [UNIFESP], Sakano, Célia Regina Souza Bezerra [UNIFESP], Ribalta, Julisa Chamorro Lascasas [UNIFESP], Baracat, Edmund Chada [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/00130000073rq
• DOI: 10.1590/S0100-72032004000200003
• Texto Completo: http://dx.doi.org/10.1590/S0100-72032004000200003; http://repositorio.unifesp.br/handle/11600/2020
• topic: Cervical intraepithelial neoplasia; HIV; Pap smear; AIDS; Colo do útero: lesões pré-neoplásicas; Colpocitologia; HIV; AIDS

PURPOSE: to correlate the type of cervical lesion diagnosed by Pap smear with CD4 cell counts and HIV-RNA viral load in HIV-positive patients. METHODS: one hundred and fifteen HIV patients were evaluated retrospectively in the present study, during the period from January 2002 to April 2003, at a university hospital. Eighty-three patients presented cervical intraepithelial neoplasia (CIN) in Pap smear, in comparison with thirty-two with no lesions. Patients were divided into three groups, according to CD4 counts: CD4 more than 500 cells/mm³, between 200 and 500 cells/mm³, and less than 200 cells/mm³, and other three groups, according to HIV viral load: less than 10,000 HIV-RNA copies/mL, between 10,000 and 100,000 HIV-RNA copies/mL, or more than 100,000 HIV-RNA copies/mL. Correlation was investigated by the Fisher test. RESULTS: of the eighty-three patients with CIN, 73% presented CD4 counts less than 500 cells/mm³. In all CD4 groups, more than 50% of the patients presented CIN. According to the viral load, 71.7% of the patients with less than 10,000 HIV-RNA copies/mL presented CIN I, compared with 11.3% that showed CIN III. In the group with higher viral load (>100.000 HIV-RNA copies/mL), 61.5% showed CIN I and 30.8% presented CIN III. CONCLUSION: association between viral load and CIN was established (p=0.013), which was not observed with CD4 cell counts and CIN. Concomitant cervicovaginal infection was considered a potential confounding factor.