Abstract
BACKGROUND: Immunocompromised women are prone to human papillomavirus (HPV) persistence and cervical cytological abnormalities. Screening them for cervical epithelial abnormalities and cancer is essential. METHOD: We conducted a prospective observational study for 2 years at a tertiary care hospital. Women between 25 and 65 years of age with any of the immunocompromised conditions-human immunodeficiency virus (HIV) positive, autoimmune disorders, chronic kidney disease, diabetes, and bronchial asthma-were recruited. After informed consent, we performed cytological screening or cotesting (cytology plus HPV). Those who were screen positive were advised for further evaluation/follow-up. Sociodemographic and clinical details were collected as per the proforma. RESULTS: Out of the 141 immunocompromised women screened, 9 (6%) tested screen positive. Among these, two were HPV positive, 6 had positive cytology, and one tested positive for both HPV and cytology. Cytological abnormalities were highest among women with diabetes mellitus 7/91 (7%); this included atypical squamous cells of uncertain significance (ASCUS): 5 (all HPV negative), ASC-H (one), and suspicion of invasive cancer (one). Among women with diabetes, cytological abnormalities were observed in those with a longer duration of the disease and multidrug medication. HIV positive women had satisfactory CD4 count (54%), and those (45%) with count <500 had extremely low viral load; except one, all were compliant with antiretroviral therapy (ART). CONCLUSION: Immunocompromised states have a higher prevalence of cervical screen positivity. The cytological abnormalities were maximum in diabetic women, which were predominantly of low grade and non-HPV related. TRIAL REGISTRATION NUMBER: CTRI/2023/03/050492.