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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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PAP Smear Shows Inflammatory Squamous Atypis. What Does It Mean? I Am HIV Positive

HI doctor currently I am on haart medicine for abt 1.5 years recently I got blood spot after 10days period over. I went for PAp smear test . result came out as Inflammatory Squamous Atypis.No evidence of malignancy and sysplasia. What does it meant ? Doctor ask me to do another pap smear after 6 months . Please adv what to do ? Since I have HIV and my viral load is below 20 and CD4 is more 400 . Is ok ? Am I in dangerous condition and I extremely worry and lost my mind . My hubby and me plan to go for fertility test. Please adv. Thank You . God Bless You. My hubby hiv negative and I am positive
Sat, 16 Feb 2013
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OBGYN,  's  Response
Hello
Thank you for your query
There is controversy about management of ASCUS ( squamous atypia ) in HIV-infected women:
Many authorities recommend that all HIV-infected women with ASCUS be referred for colposcopy.
In HIV-infected women, there are insufficient data to recommend HPV DNA testing for oncogenic HPV types as part of management of ASCUS.
If colposcopy is chosen, and no CIN is found, repeat cytology at 12 months.
If HPV testing is chosen, reflex HPV testing of samples collected during cytologic screening is preferred, for patient's convenience. This requires liquid-based cytology or samples collected specifically for HPV testing and held. Otherwise, HPV testing requires another Pap smear.
If HPV negative, repeat cytology at 12 months.
If HPV positive, manage as for LSIL (below).
If repeat cytology is chosen, repeat at 6-month intervals until 2 consecutive negative tests, then return to normal screening interval. If repeat shows ASCUS or higher, refer for colposcopy.
Basically your doctor has chosen option 3 where you will have repeat pap smear at 6 month intervals, which is correct.
Take care.
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PAP Smear Shows Inflammatory Squamous Atypis. What Does It Mean? I Am HIV Positive

Hello Thank you for your query There is controversy about management of ASCUS ( squamous atypia ) in HIV-infected women: Many authorities recommend that all HIV-infected women with ASCUS be referred for colposcopy. In HIV-infected women, there are insufficient data to recommend HPV DNA testing for oncogenic HPV types as part of management of ASCUS. If colposcopy is chosen, and no CIN is found, repeat cytology at 12 months. If HPV testing is chosen, reflex HPV testing of samples collected during cytologic screening is preferred, for patient s convenience. This requires liquid-based cytology or samples collected specifically for HPV testing and held. Otherwise, HPV testing requires another Pap smear. If HPV negative, repeat cytology at 12 months. If HPV positive, manage as for LSIL (below). If repeat cytology is chosen, repeat at 6-month intervals until 2 consecutive negative tests, then return to normal screening interval. If repeat shows ASCUS or higher, refer for colposcopy. Basically your doctor has chosen option 3 where you will have repeat pap smear at 6 month intervals, which is correct. Take care.