Prevalence, diagnosis and treatment of lower genital neoplasia in women with human immunodeficiency virus infection.
The prevalence of lower genital neoplasia and Human Papilloma-virus-related genital lesions were evaluated in a cohort of 75 women with Human Immunodeficiency Virus type 1 (HIV-1) infection at different stages of HIV disease. The overall rate of cervical intraepithelial neoplasia (CIN) in the group studied was 29.3% (22/75). Eight out of 10 high-grade CIN lesions contained 'high-risk' HPV-DNA 16/18 and/or 31/35/51 as demonstrated by 'in situ' hybridization with biotinylated probes. Vulvar and/or perianal condylomata were histologically diagnosed in 14 patients (18.7%); nine of these biopsies contained detectable HPV-DNA which was always related to HPV 6/11. The rate of high-grade CIN in symptomatic HIV-infected patients was 28% (7/25) as compared to 6% (3/50) of the other cases (P = 0.022). CD4 lymphocyte counts, white blood cell counts, CD4+/CD8+ cell ratio and percentage of CD4+ lymphocytes were lower in patients with high-grade CIN in comparison to the patients with negative colposcopical and/or cytological examination. After adequate standard treatment (cryotherapy, electrocauterization, cold-knife conization) only one case of CIN 2 recurred during the 2 years of follow-up period. The prevalence of lower genital neoplasia and HPV-related lesions among HIV-infected women is high and seems to correlate with the severity of HIV disease.
Spinillo
A
A
Department of Obstetrics & Gynaecology, University of Pavia, IRCCS Policlinico, Italy.
Tenti
P
P
Zappatore
R
R
Barbarini
G
G
Maccabruni
A
A
Carratta
L
L
Guaschino
S
S
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D001004:Anus Diseases / Q000382:microbiology; D002584:Cervix Uteri / Q000382:microbiology; D003218:Condylomata Acuminata / Q000382:microbiology; D004279:DNA, Viral / Q000032:analysis; D004848:Epithelium / Q000382:microbiology; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis; D015497:HIV-1; D006801:Humans; D009693:Nucleic Acid Hybridization; D027383:Papillomaviridae / Q000235:genetics; D014412:Tumor Virus Infections / Q000150:complications* / Q000382:microbiology / Q000601:surgery; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000382:microbiology* / Q000601:surgery; D014845:Vulvar Diseases / Q000382:microbiology
D004279:DNA, Viral; D016655:HIV Core Protein p24