Artikel
HPV- infection in HIV-infected women as a tumor marker of recurrent cervical dyplasia
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Veröffentlicht: | 20. März 2006 |
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Gliederung
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Background: Due to antiretroviral therapy, the life expectance of HIV positive women has been increasing substantially during the past decade. Nevertheless, cervical cancer remains an AIDS-defining disease according to CDC-classification. The evaluation of the recurrence rate of cervical dyplasia after surgical intervention and the rate of HPV persistence have been the aims of this study.
Methods: The retrospective analysis of HIV-positive women visiting our specialized outpatient clinic at a university hospital over the last 10 years included: results of every cervical cytology, cervical HPV detection (Hybrid Capture® 2 from Digene or a reverse line blot HPV-genotyping assay), cervical biopsy and/or other histology e.g cone biopsy, patient history and follow-up.
Results: From a cohort of 423 HIV-positive women, 388 had at least one in house cervical cytology. The whole cohort had a mean follow-up of 2,5 years with a mean of 8,2 outpatient visits.
HPV high-risk was at least at one examination positive for 197/344 patients (57,3%). 84/136 (61.8%) showed a persistent HPV-infection. 70/157 HIV-positive women with a cervical dysplasia received a surgical intervention to prevent cancer and 41/70 (58,6%) needed more than one operation because of recurrent dysplasia. All of the patients with a recurrency had a persistent HPV-infection. Although, 2 women developed a cervical cancer.
Conclusion: The recurrence of cervical dysplasia in HIV-positive women was very well associated with a persistent HPV-infection. Facing the high relapsing rate and the risk involved of experiencing cervical cancer HIV-positive women should be surveyed carefully using HPV-testing apart from cervical cytology.