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HIV-infected women do not appear to be at increased risk of cervical cancer
Date:7/22/2012

ent) of the HIV-uninfected women with normal cervical cytology at enrollment. Two cases of HSIL+ were observed during the 5 years of observation, 1 among the HIV-uninfected women and 1 among the HIV-infected women with a CD4 cell count of 500 cells/L or greater. Overall, the cumulative incidence of HSIL+ was 0.3 percent in HIV-infected women and 0.4 percent in HIV-uninfected women.

Based on a total of 15 cases, the authors found that the cumulative incidence of CIN-2+ over 5 years of follow-up was 2 percent in HIV-infected women with CD4 cell count less than 350 cells/L, 2 percent in those with CD4 cell count of 350 to 499 cells/L, 6 percent in those women with CD4 cell count of 500 cells/L or greater, and 5 percent in HIV-uninfected women.

When the researchers combined the data among HIV-infected women, they found that the overall 5-year cumulative incidence of CIN-2+ in HIV-infected women was 5 percent. "Of the CIN-2+ cases, 2 were CIN-3 (an HIV-infected woman with a baseline CD4 cell count of 350-499 cells/L, and an HIV-uninfected woman). The overall 5-year cumulative incidence of CIN-3+ was 0.5 percent in HIV-infected women and 0.7 percent in HIV-uninfected women. No cancers were observed."

"In summary, the results of this prospective study suggest that HIV-infected women undergoing long-term clinical follow-up who are cytologically normal and oncogenic HPV-negative have a risk of cervical precancer similar to that in HIV-uninfected women through 5 years of follow-up. Additional observational studies or a randomized clinical trial may be necessary before clinical guideline committees consider whether to expand current recommendations regarding HPV co-testing to HIV-infected women. More broadly, the current investigation highlights the potential for a new era of molecular testing, including HPV as well as other biomarkers, to improve cervical cancer screening in HIV-infected women," the authors conclude.


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Contact: Deirdre Branley
sciencenews@einstein.yu.edu
347-266-9204
JAMA and Archives Journals
Source:Eurekalert

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