Cervical Cancer Screening in HIV-Positive Women by Conventional Exfoliative Cytology and Liquid-Based Cytology

Background Cervical cancer remains a significant public health challenge, particularly among women living with human immunodeficiency virus (HIV), due to their increased vulnerability to persistent human papillomavirus (HPV) infections. Early detection through effective screening methods such as conventional exfoliative cytology (CEC) and liquid-based cytology (LBC) can substantially reduce the burden of cervical cancer in this population. Objective In view of the combined burden of HIV infection and cervical cancer in India, the current study aims at screening for cervical cancer in HIV-positive women attending anti-retroviral therapy (ART) centers by conventional Pap smear and LBC and also compares the results of conventional exfoliative cytology to liquid-based cytology in Gandhi Medical College and Associated Hospitals, Bhopal. Methods This cross-sectional study was conducted on HIV-positive women attending a tertiary care center. Cervical samples were collected and analyzed using both CEC and LBC techniques. The results were evaluated based on cytological abnormalities, sample adequacy, and detection rates of precancerous lesions. Data were statistically analyzed to determine the comparative effectiveness of these two methods. Results Of the 250 HIV-positive women screened using conventional exfoliative cytology, epithelial abnormalities were detected in 25 (10.0%) cases. LBC demonstrated superior sample adequacy, with 230 out of 250 samples (92%) being satisfactory, compared to 200 out of 250 samples (80%) in CEC. Additionally, LBC showed higher sensitivity in detecting epithelial abnormalities, with 29 out of 29 cases (100.0%) correctly identified, compared to 25 out of 29 cases (86.2%) detected by CEC. Both methods demonstrated high specificity, with LBC identifying 221 out of 225 true negatives (98.2%) and CEC identifying 225 out of 225 true negatives (100.0%). Conclusion Liquid-based cytology is more effective than conventional exfoliative cytology in cervical cancer screening among HIV-positive women due to its higher sensitivity and better sample adequacy. Incorporating LBC into routine screening protocols for high-risk populations, such as HIV-positive women, could enhance early detection and improve clinical outcomes.