SCREENING FOR PRECANCEROUS AND CANCEROUS LESIONS IN HIV POSITIVE WOMEN AT THE REGIONAL HOSPITAL OF BAFOUSSAM, CAMEROON

Background: Cervical cancer is one of the most frequent and severe cancers among women worldwide. In this context, screening programs targeting HIV-positive women have been implemented in developing countries, including Cameroon. However, there is a lack of data on the prevalence and determinants of precancerous lesions in HIV-positive women in the Western Region. The aim of this study was to assess the impact of screening for precancerous and cancerous lesions in HIV-positive women at the Regional Hospital of Bafoussam.

Methods: Over a four-week period, 104 sexually active HIV-positive women receiving antiretroviral therapy (ART) were followed at the Regional Hospital of Bafoussam. Cervico-vaginal samples were taken and stained using the Papanicolaou technique after collecting various study-related information. The data were analyzed using Microsoft Excel 2019, and the distribution of variables was studied using descriptive statistics through SPSS 21.0 software. The chi-square (x2) test was used to assess the relationship between risk factors for cervical cancer and the occurrence of precancerous lesions.

Results: Cytological analysis of the 104 women showed that 90.38% had normal smears, 7.69% had low-grade squamous intraepithelial lesions (LSIL), and 1.9% had high-grade squamous intraepithelial lesions (HSIL). Precancerous lesions were observed in 19.23% of women with an undetectable viral load and 7.14% of those with a viral load > 40 copies/ml. These lesions primarily affected women who had been on antiretroviral therapy for at least one year. The majority of lesions were found in women aged 31 to 65 years, with a peak in the 51-65 age group. Factors associated with a higher frequency of lesions included: 21.43% of women who had their first sexual intercourse before the age of 15, 14.28% of women with high parity, and 11.62% of married women.

Conclusion:The prevalence of precancerous lesions is high among HIV-positive women, putting them at an increased risk of developing cervical cancer if they do not receive proper therapeutic follow-up.