Prevalence of cervicovaginal human papillomavirus and cytological abnormalities in immunocompromised women at a tertiary level setting in coastal Karnataka

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.