Girls born with HIV at risk for cervical abnormalities

Adolescent girls who were infected with HIV at birth have a high risk of developing cervical abnormalities, according to research to be published in the June issue of the American Journal of Public Health. The new findings point to a potential role for the human papillomavirus vaccine in this population.

Susan B. Brogly, PhD, of the Harvard School of Public Health in Boston, and colleagues estimated the rates of pregnancy and pregnancy outcomes, genital infections, and abnormal cervical cytology among 638 adolescents aged 13 and older who were perinatally infected with HIV.

Of 101 girls in this cohort who underwent Pap tests, 48 (47.5%) had abnormal cervical cells including 18 with atypical cells of undetermined significance, 27 with low-grade squamous intraepithelial lesions, and three with high-grade squamous intraepithelial lesions. Only half of the girls who were sexually active had Pap tests, and many of the abnormalities did not clear with therapy.

"These findings underscore the importance of obtaining sexual histories, providing counseling to prevent unintended pregnancies, screening for genital infections, administering routine Pap tests, and closely managing cervical lesions," the study authors conclude.

Brogly SB, Watts DH, Ylitalo N, et al. Reproductive Health of Adolescent Girls Perinatally Infected with HIV. Am J Public Health. Published online at http:// http://www.ajph.org/cgi/content/abstract/AJPH.2005.071910v1/.