HIV infection and invasive cervical carcinoma in an Italian population: the need for closer screening programmes in seropositive patients.
OBJECTIVE
To evaluate in an Italian population the prevalence, characteristics at first diagnosis and outcome of HIV-seropositive individuals with cervical carcinoma referred to a tertiary-care institution.


METHODS
A retrospective evaluation of all patients referred for invasive cervical carcinoma from 1991 to 1994.


METHODS
The departments of obstetrics and gynaecology, and radiotherapy at San Gerardo Hospital, University of Milan, Italy.


METHODS
A total of 340 women were treated over a 3-year period (186 aged < 50 years). Six patients were found to be HIV-seropositive.


METHODS
Seropositive patients were treated according to current institutional protocols, irrespective of HIV status. Four underwent radiotherapy and two radical hysterectomy as primary treatment.


RESULTS
Although five HIV-seropositive patients were known to be infected 13-81 months before diagnosis of cervical cancer, none had received a PAP smear in the last year and only one in the last 2 years. HIV patients were younger than general population (P = 0.02), with a significant history of intravenous drug use (P = 0.000001) and with more advanced disease (P = 0.04). Two HIV-positive patients also received polychemotherapy (one adjuvant and one salvage treatment) and both completed the planned treatment. Within 24 months two patients had died of cancer and one of AIDS; one is alive with AIDS and cancer and two are free of disease.


CONCLUSIONS
This study confirms that in a southern European population, HIV-seropositive women present to tertiary-care institutions with more advanced disease and have a poorer prognosis than the general population. Strict screening programs for cervical dysplasia and cancer are warranted for HIV-seropositive patients.
Zanetta
G
G
Department of Obstetrics and Gynaecology, S. Gerardo Hospital, University of Milan, Monza, Italy.
Maneo
A
A
Colombo
A
A
Ragusa
A
A
Gabriele
A
A
Placa
F
F
Mangioni
C
C
D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control