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1994-10-25
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Document 2598
DOCN M94A2598
TI Cervical dysplastic lesions among HIV-seropositive pregnant women.
DT 9412
AU Spinillo A; Iasci A; Maccabruni A; Piazzi G; Nicola S; Baltaro F;
Department of Obstetrics and Gynecology, University of Pavia,; Italy.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):268 (abstract no. PB0501). Unique
Identifier : AIDSLINE ICA10/94369977
AB OBJECTIVE: To evaluate the frequency and natural history of cervical
intraepithelial neoplasia (CIN) during pregnancy in women with human
immunodeficiency virus type 1 (HIV-1) infection. METHODS: We evaluated
prospectively 23 pregnant HIV-1 seropositive patients and 18
HIV-seronegative controls. Follow-up visits were carried-out each
trimester of pregnancy and 8-12 weeks post-partum with Papanicolaou
smears, colposcopic examinations and, when necessary, colposcopically
directed cervical biopsies. In situ hybridization to detect human
papillomavirus DNA types 6/11, 16/18 and 31/35/51 was performed on
cervical biopsies with biotinylated probes. During pregnancy, in the
absence of signs of progression, squamous intraepithelial cervical
lesions were managed conservatively. RESULTS: Eight of 23 (34.8%)
HIV-seropositive women and 2 of 18 (11.1%) HIV-seronegative controls had
biopsy-proven CIN (P = 0.08 by Fisher exact test). Cervical carcinoma in
situ (CIN III) was detected in 5 cases (21.7%) and in none of the
controls (P = 0.04 by Fisher exact test). All the severe lesions stained
positive for human papillomavirus types 31/35/51. None of the cervical
squamous intraepithelial lesions progressed throughout pregnancy, in
both cases and controls. Post-partum cold-knife cervical conization was
performed on 5 patients with CIN III. Examination of the conization
specimens demonstrated persistence of CIN III with the same viral types
identified on preconization biopsy specimens. CONCLUSIONS:
HIV-seropositive women are at high risk of CIN during pregnancy. Our
preliminary data suggest that the progression rate of CIN during
gestation is low.
DE Adult Biopsy Cell Transformation, Neoplastic/PATHOLOGY Cervical
Intraepithelial Neoplasia/PATHOLOGY Cervix Dysplasia/*PATHOLOGY Cervix
Neoplasms/*PATHOLOGY Cervix Uteri/PATHOLOGY Female Follow-Up Studies
Human HIV Seropositivity/*PATHOLOGY *HIV-1 Neoplasm Staging
Pregnancy Pregnancy Complications, Infectious/*PATHOLOGY Pregnancy
Complications, Neoplastic/*PATHOLOGY MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).