Cervical dysplasia in postmenopausal patients infected by HIV

An increasing number of patients infected with HIV reach the age of menopause. HIV infection is associated with a higher incidence of cervical dysplasia. The aim of our study was to describe cervical abnormalities observed in these patients during menopause.

Retrospective study at Louis Mourier Hospital, comprising all cervical cytologic and colposcopic examinations in post-menopausal HIV-infected women from 1995 to 2008.

In 18 postmenopausal patients, median age 54 years (range 43 to 63) diagnosed with HIV-1 infection for 7,5 years (range 2 to 25), 51 samples were analyzed. There were 27 (50.98%) abnormalities, including 4 (7,84%) ASC-US, 15 (29.41%) low-grade lesions, and 7 (13.73%) high-grade lesions. Ten of these patients underwent surgery (laser, conization, hysterectomy) during this period. During follow-up, the lesions were stable in 40.48%, regressed in 35,71%, and progressed in 23.81%. In our study, the median onset of high-grade dysplasia during menopause is 5 years.

Cervical lesions were frequent in postmenopausal HIV-infected women, mostly low grade and persistant. Women with HIV infection should continue to have gynaecological follow-up, with baseline HPV typing and a yearly Pap tests.