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Special situations: abnormal cervical cytology in immunocompromised patients.

Background The association of human papillomavirus (HPV) infection and cervical dysplasia has been well established, and it is no surprise that immunocompromised patients have a higher risk of cervical dysplasia and invasive cervical cancer. This has been described in both immunosuppressed transplant and cancer patients and in women infected with the human immunodeficiency virus (HIV). Furthermore, women infected with HIVare more likely to be infected with HPV, partly due to the fact that both viruses are sexually transmitted. The risk of invasive cervical cancer in patients with acquired immunodeficiency syndrome (AIDS) has been well documented. Gallagher et al reported that women with AIDS have a relative risk of 6.5 for developing cervical cancer. Klevens et al evaluated 16,794 patients with AIDS and found that 1.3% had invasive cervical cancer. Given this higher rate of cervical cancer among HIV-infected women, the Centers for Disease Control has designated invasive cervical cancer as an AIDS-defining illness. This higher risk of cervical cancer underscores the need for adequate cervical dysplasia screening among HIV-infected women.