CD4 and squamous cell intraepithelial neoplasia: The independent association between SIL and severe immunosuppression was retained after controlling for the use of antiretroviral drugs, confirming the independent effect of severe immunosuppression with poor clearance of HPV from cervical cells and eventual transformation of SIL to invasive cancer [14], [17], [18], Agaba et al [19] and Sewande et al [22] reported that the immunosuppressive effect, measured by the decrease in CD4 cell count, is the greatest predictor of cervical lesion development in HIV-positive women.