The Cytopathological and Molecular Aspects of Dysplasic Lesions of the Cervix: Particularities to Patients Living with Hiv Followed at Panzi General Reference Hospital
Authors:   Gynecology and Obstetrics Service, Panzi General Reference Hospital, Olivier Nyakio ,   Department of Gynecology and Obstetrics, Evangelical University in Africa (UEA),   International Advanced Center for Research and Training (ICART), Fabrice Kibukila ,   Department of Gynecology and Obstetrics, Bukavu State University (UOB), Tchass Chasinga ,   Anatomopathology Service, Panzi General Reference Hospital, Murenz Gad ,   Rwanda Military Hospital, Joyeux Bwami ,   Gynecology and Obstetrics Service, Panzi General Reference Hospital, Bertin Kasongo ,   Provincial Division of Health (South Kivu), Tambwe  ,   Department of Gynecology and Obstetrics, School of Medecine, University of Lubumbashi, Albert  ,   Department of Gynecology and Obstetrics, School of Medecine, University of Lubumbashi, Prosper Kakudji ,   Department of Gynecology and Obstetrics, School of Medecine, University of Lubumbashi, Prosper Kalenga ,   Department of Gynecology and Obstetrics, School of Medecine, University of Lubumbashi, Baptiste Kakoma Jean ,   Department of Gynecology and Obstetrics, School of Medecine, University of Lubumbashi
Published: September 2021

Introduction: Cervical cancer is one of the most common cancers and takes the second place among women's cancers in terms of incidence and the first place in terms of breast cancer mortality. Its incidence and mortality are significantly increased in patients living with HIV / AIDS. The purpose of this work is to describe the cytopathological and molecular aspects of cervical dysplasia in HIV-positive women in our environment and to look for some associated factors, in particular the degree of immunosuppression and the clinical stage. Methodology: This was a cross-sectional, descriptive, and analytical study of cervical-uterine smears (n = 111) and human papillomavirus genotyping (n = 73) in HIV-infected patients received from January 2018 to December 2018 at Panzi GRH (South Kivu, DR Congo). The data analysis was done using SPSS statistics 20 software. Results: The average age of the patients was 42.25 ± 10.42 years. The cervical-uterine smear (CUS) was normal in 82.9% of cases and cytological abnormalities were found in 13.5% of cases. The majority of patients were in WHO stages I (45.9%) and II (45.0%) of HIV infection and had a CD4 count greater than 500 cells / mm3 in 47.9% of patients. Among the 73 patients who had been tested for HPV infection, 35 (47.9%) were positive. The most common carcinogenic genotype among HPV positive patients was 18-45 (17.1%). There was not a significant difference in carcinogenic genotypes and intraepithelial lesions as a function of WHO clinical stages (p = 0.3819 and p = 0.7945). Conclusion: The coexistence between HIV and HPV infections seems to be strongly associated with the occurrence of cervical cytological abnormalities in our sample study. Hence the need, on the one hand, for a national policy for early detection of cervical cancer in all patients living with HIV / AIDS, and on the other hand, for deepened studies at the international level for the tuning of a plurigenic vaccine containing all oncogenic genotypes, those one that are geographically widespread (genotypes 16 and 18) are not more common to HIV-positive patients in our study environment